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Biomedical subjects

C L Casterline

Publications and source records attributed to C L Casterline.

12 recordsLinked to original sources
PubMed1979

Aspirin idiosyncrasy.

Aspirin idiosyncrasy is infrequently discussed in the dental literature. The severity of the case described illustrates the importance of complete familiarity with the syndrome. Because the patient who is sensitive to the drug may not volunteer this information, the dentist must include specific questions about asthma, nasal polyps, and adverse clinical reaction to aspirin in the initial interview of the patient. Suspicion of this idiosyncrasy will result in avoidance of aspirin; this may well prevent a life-threatening reaction. Acetaminophen is a safe alternative analgesic agent for such patients.

Aspirin↗
PubMed1978

Selective IgA deficiency and Pi ZZ-antitrypsin deficiency. Association with recurrent sinopulmonary infections, emphysema, and bronchiectasis.

We describe a patient in whom selective IgA deficiency and homozygous alpha1-antitrypsin deficiency were discovered. Clinically, the patient suffered from chronic sinopulmonary infections, destructive emphysema, and bronchiectasis. The interrelation of IgA and alpha1-antitrypsin was studied. Twenty-three alpha1-antitrypsin-deficient sera were screened for IgA deficiency. None of these sera were deficient in IgA. Fifteen IgA-deficient sera were screened for alpha1-antitrypsin deficiency. In this group, three patients were found to have variant alpha1-antitrypsin phenotypes. Respiratory infections were a prominent complaint in all three of these patients, with bronchiectasis in two patients. We believe that the combination of IgA and alpha1-antitrypsin deficiencies should be considered in the evaluation of any patient with idiopathic bronchiectasis.

Bronchiectasis↗
PubMed1977

Squamous cell carcinoma of the buccal mucosa associated with chronic oral polyvinyl chloride exposure: report of a case.

The following case report describes a 22-year-old healthy man, non-smoker, non-drinker, who developed a squamous cell carcinoma of the buccal mucosa. The appearance of this unusual tumor in an unexpected clinical setting was unexplained until it was discovered that the patient had a lifetime habit of chewing plastic materials containing polyvinyl chloride (PVC). The extent and chronicity of his intense oral exposure to PVC is believed to be related to his subsequent development of an oral neoplasm. Attention is again focused on PVC as an important environmental toxin and carcinogenic agent. Clarification of the content of PVC in consumer products is urged. Physicians must remain aware of possible environmental carcinogens in patients presenting with unexpected or rare malignancies. Detection of such exposure may well prevent subsequent development of additional unexplained neoplasms.

Administration, Oral↗
PubMed1977

Further studies on the mechanism of human histamine-induced asthma: the effect of an aerosolized H1 receptor antagonist (diphenhydramine).

This study was designed to better define the mechanism of histamine-induced bronchoconstriction in humans by pharmacologic manipulation of the postulated bronchial histamine receptor sites. Histamine challenges were performed on a heterogeneous group of adult asthmatic subjects. The cumulative units of histamine required for induction of a sustained 20% or greater decrease in FEV1 from baseline were determined. The effect of pretreatment with an aerosolized H1 receptor antagonist, diphenhydramine hydrochloride, was then studied. Analysis of the data showed that the administration of an H1 receptor antagonist prior to histamine challenge significantly blocked the bronchial response to histamine (p less than 0.005). This effect was considered to be due to specific competitive antagonism at the H1 receptor site and suggests the presence of H1 receptors in human bronchial mucosa.

Asthma↗
PubMed1976

The effect of atropine and albuterol aerosols on the human bronchial response to histamine.

This study was designed to determine whether histamine-induced bronchoconstriction in human asthmatics is mediated by the parasympathetic nervous system and involves cholinergic pathways. Inhalation challenges were performed on 14 adult asthmatic patients using the standardized procedure for inhalation challenge recently recommended by the Asthma and Allergic Disease Centers panel. The effect of pretreatment with either aerosolized atropine sulfate or aerosolized albuterol, a specific beta-2 adrenergic agonist, was studied. The comulative units of histamine required for induction of a positive bronchial response (20% or greater drop in FEV1 from baseline) was used as the basis of comparison of the effects of these drugs. This value was expressed as the PD20-FEV1 to histamine. Analysis of the data showed that aerosolization of sufficient atropie to effect a cholinergic blockade, as shown by inhibition of the bronchial response to inhaled methacholine, only minimally affected the bronchial response to histamine (p less than 0.05). However, the administration of albuterol markedly shifted the response to histamine (p less than 0.005). Although there was a statistically significant change in the mean PD20-FEV1 to histamine following atropine blockade, this effect was small in comparison to that which could be demonstrated with a beta agonist. It would thus appear that the major influence of histamine is not through cholinergic pathways.

Administration, Intranasal↗
PubMed1976

Quantitative levels of immunoglobulin E in advanced tuberculosis.

Quantitative levels of immunoglobulin E (IgE) were determined in samples of sera obtained from 29 patients with proven moderate to far-advanced tuberculosis. The sensitive radioimmunoassay test for IgE was used. Statistical analysis of the results revealed no difference in IgE values as compared to a control group of normal sera. In contrast to other chronic pulmonary infections, such as bronchopulmonary aspergillosis, the IgE level in pulmonary tuberculous infection is of no diagnostic significance. Simultaneous determination of levels of immunoglobulins G, A, M, and D (IgG, IgA, IgM, IgD) in these same sera by radial immunodiffusion showed elevated IgG and lowered IgM levels in the tuberculous patients, confirming previous studies. The significance of these alterations in immunoglobulin levels is unclear and may represent a secondary phenomenon rather than a primary host response.

Adult↗
PubMed1975

Intolerance to aspirin.

The aspirin intolerance syndrome is characterized by rhinitis and/or sinusitis, nasal polyposis and asthma, with or without a history of adverse reactions, following aspirin ingestion. The frequency of this syndrome in a total population of patients with asthma and/or rhinitis has recently been estimated to be 2.4 percent. Aspirin-intolerant individuals can tolerate sodium salicylate and acetaminophen but indomethacin, morphine, codeine and certain pharmaceutical dyes may cause adverse reactions. The mechanism of aspirin intolerance is as yet unclear but does not appear to be on an immunologic basis. Treatment includes strict avoidance of aspirin and symptomatic therapy of rhinitis and asthma.

Aspirin↗