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Biomedical subjects

W P King

Publications and source records attributed to W P King.

17 recordsLinked to original sources
PubMed1999

The use of low-dose histamine therapy in otolaryngology.

Low-dose histamine therapy has been prescribed by otolaryngologists primarily to treat Bell's palsy, vestibular disorders, vascular headache, Ménière's attacks, and urticaria vasculitis. The scientific explanations for the usefulness of this once-empiric treatment are becoming more apparent. Two methods of establishing the appropriate dosages have emerged: the empiric, optimum-dosage approach and the objective, endpoint-titration approach. In this article, the author describes and recommends the latter approach. The author also reports on a 100-patient retrospective clinical study that revealed that the objective, endpoint-titration approach was effective in treating 80% of patients. In light of such success and the ease and economy of this treatment, low-dose histamine therapy appears to be a valuable clinical tool.

Dose-Response Relationship, Drug↗
PubMed1998

Alternatives in the diagnosis and treatment of food allergies.

The diagnosis of food allergy remains a difficult and often inexact proposition, with the treatment being equally cumbersome and complex. For this reason a variety of approaches have been developed, varying in acceptance and approval. Although many approaches represent alternative medicine, today's alternative may be tomorrow's standard.

Administration, Oral↗
PubMed1992

Food hypersensitivity in otolaryngology. Manifestations, diagnosis, and treatment.

Diet hypersensitivity may be "allergic," that is, caused by some form of immunologic reaction, or nonallergic. The latter includes chemical pharmacologic, enzymatic, or dietary disorders. Food allergies may be immediate Gell and Coombs type I reactions (5%), or delayed "serum sickness" type reactions (95%). The latter type is influenced by frequency of exposure. Any inflammation of the intestinal tract allows abnormal absorption of more allergenic food megamolecules. Manifestations of food allergy seen frequently by the otolaryngologist are legion, afflicting all areas of the discipline's concern. Diagnostic techniques rely on singly or some combination of history taking, challenge testing, and skin testing. The intracutaneous progressive dilution food test is the standardized skin test procedure now taught by the American Academy of Otolaryngic Allergy. Treatment techniques include specific dietary abstinence, a rotary diversified diet, and neutralization immunotherapy.

Diagnosis, Differential↗
PubMed1991

The intracutaneous progressive dilution multi-food test.

Data have been published supporting the view that skin response is more valid and reliable than symptom provocation for interpretation of the intracutaneous provocative food test (IPFT). As such, an intracutaneous progressive dilution food test technique interpreted by skin response is now the standard IPFT technique taught at American Academy of Otolaryngic Allergy-sponsored courses. While this test technique is less time-consuming than the 5-day oral challenge food test of Rinkel, the 15- to 90-minute per test demand still presents a significant deterrant to widespread use. Here we present a time-efficient, multi-test technique that allows testing of three to seven foods at one time. The technique is not recommended for use on patients with a history of severe allergic reactions, such as asthma or angioedema, or for testing any food that by history may produce an anaphylactic reaction.

Food Hypersensitivity↗
PubMed1990

The evolution of otolaryngic allergy practices.

We review the evolution of the allergy diagnosis and treatment techniques endorsed by the American Academy of Otolaryngic Allergy. These endorsements were made only after careful consideration of supporting data accumulated during their evolution.

Food Hypersensitivity↗
PubMed1989

Clinical significance of molds newly available for radioallergosorbent testing.

Three years of weekly Rotorod airborne allergen reports from Corpus Christi, Texas, were reviewed. Five of 10 newly available airborne molds for radioallergosorbent testing (RAST) were present in significant numbers. Three hundred seventy-five mold RAST evaluations were expanded to include the five old and these five new molds. Except for Alternaria, the frequency of and allegenic response to the new molds were generally greater than those for the five old molds. The usual Alternaria-Cladosporium mold screen proved less satisfactory when these five new molds were added to the mold battery; however, the addition of Helminthosporium to the screen corrected this deficiency. Cross-reactivity production of false-positive responses seems unlikely because of frequent significant variance in RAST scores from mold to mold in the same patient.

Air Microbiology↗
PubMed1989

Efficacy of alternative tests for delayed-cyclic food hypersensitivity.

With the oral challenge food test (OCFT) used as the standard for delayed-cyclic food hypersensitivity diagnosis, blinded comparison studies were accomplished with 175 in vitro food specific IgE and 180 IgG radioallergosorbent tests, 180 food enzyme-linked immune complex assays, and 155 in vivo Multi-Test prick tests. The study was multi-centered, eight physicians and 37 patients participating. All of the compared tests were shown to be approximately 50% efficient when compared with the OCFT results, and, thus, nonefficacious.

Double-Blind Method↗
PubMed1988

Provocation-neutralization: a two-part study. Part I. The intracutaneous provocative food test: a multi-center comparison study.

This study investigated the clinical usefulness of the intracutaneous provocative-neutralization food test (IPFT). Thirty-seven patients were tested for five identical food allergies by eight physicians in different geographical locations. Throughout the study, comparison was made between the IPFT when interpreted by skin response (IPFT SK) and when interpreted by symptom provocation (IPFT PR). Double-blind IPFT results were compared with those of previously accomplished oral challenge food tests (OCFT). IPFT reliability was determined by a double-blind comparison of the initial IPFT, with two subsequent IPFTs performed 7 days apart. Correlation of the IPFT SK and IPFT PR with the OCFT provided validity coefficients of 0.78 and 0.61 respectively, both significant beyond the 0.01 level of confidence. Reliability of the IPFT SK and IPFT PR was shown to be 0.68 and 0.40, respectively. The IPFT SK was significant beyond the 0.01 level of confidence and the IPFT PR was significant beyond the 0.05 level of confidence.

Adolescent↗
PubMed1988

Provocation-neutralization: a two-part study. Part II. Subcutaneous neutralization therapy: a multi-center study.

Presented is a triple-blind crossover study that investigates the efficacy of subcutaneous neutralization food hypersensitivity therapy. Seven physicians and thirty-three patients from various parts of the country participated. Each patient underwent three 2-week treatment sessions, with 1 week off treatment between each session. During each treatment session, one injection a day was given. The injection consisted of a placebo for one 2-week session, and the active allergen during the other two sessions. The active dose was determined by earlier intracutaneous provocative food testing. The diet during the study period was not varied. Medication-symptom diaries were maintained and treatment result evaluations for both individual complaints and overall results were detailed on a standard form at the end of each treatment session. While the number of foods treated per patient varied from 1 to 13, the majority were treated with 3 to 5 foods. Treatment with the active medication was more efficacious than with placebo. A few patients' symptoms were aggravated with the active medication. This indicates a correct diagnosis, but incorrect treatment dose. In the clinical setting such adverse response should be reversed. Overall, neutralization subcutaneous treatment should be beneficial approximately 75% of the time, and further enhanced by supplemental diet manipulation.

Allergens↗
PubMed1985

Allergic disorders in the otolaryngologic practice.

The diagnosis and treatment of otolaryngic allergy is an integral part of the specialty of otolaryngology. By combining special medical and surgical expertise, the otolaryngologist should be able to more effectively manage the many allergic afflictions of the ear, nose, throat, head, and neck areas. At the very minimum, the otolaryngologist must appreciate the importance of otolaryngic allergy diagnosis and management and include allergy in the differential diagnoses where appropriate. If the otolaryngologist is professionally prepared and physically equipped to manage such problems, the patient will profit.

Child↗
PubMed1982

Efficacy of a screening radioallergosorbent test.

Controversy over the routine use of the radioallergosorbent test (RAST) for initial inhalant allergy diagnosis largely concerns expense to the patient. Presented is a method for utilizing the RAST, with all its inherent advantages, at a competitive cost to both negatively and positively responding patients. The initial use of a "screening" RAST that utilizes approximately one third the number of tests in the usual full RAST battery is recommended. When all responses on the screening RAST battery are negative, further RAST testing proves generally unnecessary. For positive responders, the screening RAST often eliminates the need of additional pollen and/or mold allergen testing, a further cost-containment feature. The presented study illustrates the efficacy of this technique. A background section is provided to familiarize the reader with the common modalities available for testing and treating IgE-mediated inhalant allergies.

Cost-Benefit Analysis↗
PubMed1980

Liquid chromatography with amperometric detection for determinging phenolic preservatives.

Liquid chromatography with amperometric detection is a rapid and sensitive method for determining commonly encountered phenolic antioxidants including 3(2)-tert-butyl-4-hydroxyanisole, tert-butylhydroquinone, n-propyl gallate, nordihydroguaiaretic acid, and 2,6-di-tert-butyl-4-hydroxymethylphenol (Ionox-100), and the antimicrobial parabens, in a variety of commercial products. Sample extracts are chromatographed directly with few interferences on the reverse phase system. The typical linear range extends from 10(-11) to 10(-6) mole of injected analyte. Pertinent experimental factors are discussed with regard to the requirements of the detector and optimizing the determination of this class of compounds.

Antioxidants↗
PubMed1980

Liquid chromatography with amperometric reaction detection involving electrogenerated reagents: applications with in-situ generated bromine.

We describe the use of electrogenerated reactants for continuous on-line reaction detection with thin-layer hydrodynamic amperometry. The reagent is introduced into the liquid-chromatographic column effluent at a constant rate by using controlled-current electrochemistry. After the effluent passes through a short reaction coil, the reagent concentration is monitored at the detector. Reaction of eluted compounds with bromine is signalled by changes in the current detected. The direct electrochemical control of the reagent concentration allows changes to be made, even during the course of obtaining a chromatogram. Depending on the specific reagent or reaction, the reagent is supplied either by addition of a second stream or by direct generation in the mobile phase. The latter configuration provides sufficient baseline stability to permit detection of the uptake of as little as 10 pmol of reagent bromine. The technique has been used to detect nanograms of underivatized fatty acids, prostaglandins, and phenols after separation by reversed-phase liquid chromatography.

Bromine↗
PubMed1978

Testing for food allergy: a statistical comparison of cytotoxic and intracutaneous tests.

This study presents a comparison of in vitro cytotoxic food allergy test results with those of in vivo intracutaneous food allergy testing by both objective serial dilution titration and subjective provocation. During the study the cytotoxic test was utilized as a screening device for follow-up Lee intracutaneous testing, the latter providing statistics for both noted in vivo intracutaneous tests. The study is presented in two stages. The first stage documents almost 6000 comparison test results on 300 consecutive food-allergic otolarynogology patients. Thirty-four of the more frequently offending foods were utilized. Of the cytotoxic tests, 86% resulted in positive reactions. Of the positive cytotoxic reactors, 74% were intracutaneously re-checked. Only those negative cytotoxic reactors suspected of false negativity were so challenged, affording comparison statistics for a smaller 21% of the negative reactors. Poor correlation statistics for this select negative reacting group prompted a follow-up 30-patient study on 11 foods that appeared to possess a lesser potential for hypersensitivity production. The second stage emphasizes similar test comparisons on the negative cytotoxic reactors. The study concludes that no correlation exists between in vitro cytotoxic test determinations and those of in vivo intracutaneous testing by objective serial dilution titration or subjective provocation. Because most allergic individuals have multiple food allergies, clinical success utilizing the information obtained from any or all of these procedures may rely significantly on the tests' inherent tendency to identify multiple guilty foods for ultimate treatment.

Cytotoxicity Tests, Immunologic↗