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BACKGROUND The basophil activation test relies on flow cytometric quantitation of the expression of themarkers on the surface of basophils, after stimulation with the amount of allergen thatcross-link IgE antibodies bound on their surface. In allergy diagnosis, the technique hasbeen applied in the investigation of IgE-mediated allergy caused by classical inhalant allergens,Hevea latex, food, drugs and hymenoptera venoms. The technique also proves valuablein the diagnosis of non-IgE-mediated reactions such as drug hypersensitivity and thedetection of autoantibodies in certain forms of chronic urticaria. To strengthen the probabilitythat the working diagnosis for hymenoptera venom hypersensitivity is correct, confirmatorytesting for skin test and IgE antibody is often performed. But sometimes clinical history and the results of confirmatory tests are contradictory. In such cases additionaltests are necessary, among which flow cytometric quantification of in vitro basophil activationis becoming a valuable tool during the last few years.Material and In Laboratory for Clinical Immunology and Molecular Genetic, Golnik, we performed BATmethods for 127 patients with history of anaphylactic reactions after Hymenoptera sting. CONCLUSIONS According to our findings BAT is a highly sensitive and specific technique and as an invitro provocation assay enables sensibilisation detection, prediction of side effects fromspecific immunotherapy and differentiates between clinically relevant and irrelevant epitops.This technique also gave us a new information on mechanisms and effects of venomimmunotherapy

Background. Fire-eaters use liquid hydrocarbons for the performance of the flame-blowing and flame swallowing show. Aspiration of hydrocarbon mixture may cause severe lipoid pneumonia. We present two patients who developed severe lipoid pneumonia after an accidental aspiration of petroleum and paraffin during a flame–blowing act.Conclusions. Prolonged treatment with antibiotics and systemic corticosteroids was successful. Radiological resolution occurred three months after the accident

Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%), tachypnea, cough (67%) and confusion (47%) dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%), have leucocytosis (63%), electrolyte disturbances and elevated urea (67%). According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high. Effective therapy is composed from adequate support measures and proper choice of antibiotic – amoxycillin with clavulanic acid, cephalosporines of high generation or antipneumococcal quinolone.

Background. New pathologic classification of interstitial pulmonary diseases of unknown etiology from 1998 enables better clinical approach to these diseases already in their early stages. As a result, key parameters for treatment choice and prognosis are easier to summarise.Conclusions. The article presents the basis for new pathologic classification and its role in clinical practice. In addition, the lastest international multidisciplinary consensus of pathological/clinical classification of ihese diseases, having been edited by American Thoracic Society and European Thoracic Society in June 2001, is presented. Every individual entity is illustrated with corresponding histologic pattern of our recently hospitalised typical cases. Finaly, some new therapeutic approaches are introducted which are oriented to actual immunopathogenetic stage of interstitial pulmonary disease.

Background. Venomenhal® (V) is a new brand ofHymenoptera venom allergen for diagnosis and immunotherapyof venom allergy. We studied the safety of switching thepatients treated with other brands of venom to V. Methods. We performed duplicate skin prick tests with V andALK Reless® (R) venom extract (100 μg/ml) in 68 patients (50males, 42 ± 15 years) on maintenance immunotherapy withhoney bee (26) or wasp (42) venom. On two consecutive maintenanceinjection days 53 patients received in random ordereither 100 μg of R or V venom. Results. Weal diameter in skin prick tests (mean ± st.dev.) were3.9 ± 1.1 mm (V) and 4.1 ± 1.0 mm (R) for bee venom (NS)and 3.4 ± 1.0 mm (V) and 3.9 ± 1.2 mm (R) for wasp venom (p< 0.01). Local reaction 30 minutes after maintenance injectionwere 6.1 ± 1.7 cm (V) and 5.4 ± 2.5 cm (R) for bee venom(NS) and 5.1 ± 1.8 cm (V) and 6.1 ± 1.8 cm (R) for wasp venom(p < 0.05).Late local reactions (LLR) and tiredness (T) on the day of injectionand 24 hours after injection were equally distributedamong both groups and were mild (LLR on the day of injection:38% of patients [V] vs. 43% [R]. LLR after 24 hours: 28%[V] vs. 28% [R]. T on the day of injection: 21% [V] vs. 23% [R].T after 24 hours: 0% [V] vs. 6% [R]). Conclusions. V was at least as safe as A. There were no adversereactions due to switching from one brand to another. Slightlybut significantly smaller weal in skin prick tests and immediatelocal reactions might be due to lesser potency or betterpurification of V wasp extract.