Nasal endoscopy: an advancement in diagnosis and treatment of sinusitis.
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Biomedical subjects
Publications and source records attributed to S A Imbeau.
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We report herein a woman sensitive to nylon stockings of only brown or tan shade. Her situation is interesting for several reasons: she does not react to paraphenylediamine and she reacts to red and yellow dyes, but not to blue or the finish; however, when finish is applied to dyed blanks (red, yellow, or blue) she reacts vigorously to all three. We suspect the finish reacts with the dyes to either expose or produce an antigen previously not available to the skin.
After one year's use of beclomethasone dipropionate aerosol, 43 of 61 asthmatic patients who were originally dependent on oral corticosteroids were able to reduce and 38 to completely eliminate use of oral corticosteroids. Most patients maintained or improved their pulmonary functions. Exacerbation of rhinitis during oral corticosteroid withdrawal and emergence of nasal polyps were problems for 25 patients. Exacerbation of asthma with upper respiratory infection was an important event: 21 patients required supplemental oral corticosteroids to control asthma. Oral candidiasis occurred in only three patients.
Allergic bronchopulmonary aspergillosis (ABPA) is an unusual syndrome caused by hypersensitivity to Aspergillus spores growing in the bronchii. Previous investigators have suggested that the IgE levels and precipitating antibodies may vary according to disease activity. We have been able to closely follow 12 out of a group of 40 ABPA patients with IgE and serum precipitating antibody measurements. Our results confirm that both the total serum IgE and the precipitin response vary according to ABPA disease activity. In particular the IgE trend appears to mirror the disease activity in that a rising level may portend a flare, while a stable or declining value implies disease remission.
Beta adrenergic agents are known to inhibit mediator release from skin and lung mast cells in vitro and isoproterenol and epinephrine are known to impair the immediate allergic skin test reaction. We undertook to investigate the effects of aqueous and oral terbutaline on the allergy skin tests. We particularly wished to analyze the impact of terbutaline on the late allergic reaction, but we found that terbutaline mixed with ragweed antigen does not affect either the immediate or late skin test reaction. Furthermore, 5 mg of oral terbutaline does not inhibit the immediate allergic skin test.
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Fifty consecutive patients with allergic asthma and/or rhinitis in Madison. Wisconsin, were tested intradermally with a house dust extract (1:100) and with a Dermatophagoides farinae antigen (1:2000). The close relationship between the two skin test results (mite and house dust) suggests that both contain the same cross-reacting antigens and that mites make a major contribution to the antigens in house dust in Wisconsin.
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Allergic bronchopulmonary aspergillosis (ABPA), a serious complication of asthma, is thought to rarely afflict infants. We report three children less than 2 years of age in whom this disorder developed. The major criteria for the diagnosis include: (1) asthma, (2) recurrent pulmonary infiltrations with peripheral eosinophilia, (3) positive aspergillus skin tests at 15 minutes and at 4 to 6 hours, (4) serum precipitating antibodies to aspergillus, and (5) elevated serum IgE levels. Early diagnosis and treatment of ABPA in infants may prevent the ravages of the disease and help to sharpen our concepts of the course and immunopathogenesis.
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