Chronic Allergy Research Articles

鼻副鼻こう粘膜の生化学的研究 糖たんぱくを中心に

Glycoprotein profiles were studied in tissues of maxillary mucosa, nasal polyp, nasal papilloma and maxillary cancer by affinity chromatography on lectin conjugated agarose and SDS-polyacrylamide gel electrophoresis. Sialyltransferase activities were measured in maxillary sinus mucosa, nasal polyps of chronic sinusitis, retained fluid in the maxillary sinus, inferior turbinates and nasal secretions of patients with chronic sinusitis or nasal allergy, and their sialic acid content was determined by the thiobarbituric acid method of Aminoff. These data were correlated with the histopathological characteristics of the mucosa. The distribution of the glycoconjugates in the maxillary mucosa was determined with the use of lectin (Con A, WGA, RCA and PNA) conjugated with FITC.(1) Glycoprotein profiles of nasal polyps were similar to those of maxillary sinus mucosa in receptors for Con A, WGA, RCA and PNA.(2) Low molecular weight (below 15, 000 daltons) components were detected in receptors for Con A, WGA and RCA in nasal papillomas.(3) PNA receptors of molecular weight about 65, 000 were numerous in nasal polyps and maxillary sinus mucosa, scarce in nasal papillomas and not detectable in maxillary cancer.(4) Sialyltransferase activity was somewhat higher in the polypous group than in the fibrous group of maxillary sinus mucosa.(5) Sialyltranferase activity in the soluble fraction was markedly higher in the tissue of maxillary sinus mucosa and nasal polyp than in the other tissues.(6) The quantity of sialic acid in the soluble fraction was higher in nasal secretions and retained fluid in the maxillary sinus of patients with chronic sinusitis than in the nasal secretions of patients with nasal allergy.

Recurrent Acute Appendicitis With Erythema Annulare Centrifugum

Erythema annulare centrifugum (EAC), a chronic figurate eruption, occurred in a 28-year-old male physician several months following the onset of recurrent abdominal pain. Two months after the manifestation of EAC, another episode of abdominal pain culminated in appendectomy for perforated appendicitis. During his convalescence, the skin lesions faded and did not reappear. We propose that recurrent appendiceal inflammation caused both the episodic pain and the skin eruptions. Additionally EAC may be a sign of chronic infection, internal malignancy, or food allergy. Although truly chronic appendicitis is a disputed entity, recurrent, spontaneously resolving episodes of appendicitis occasionally do precede surgical appendicitis. The presence of EAC in a patient having recurrent abdominal pain should discourage a precipitant diagnosis of functional illness and prompt further investigation.

Quantitative analysis of sialic acid and L-fucose in the patients with chronic sinusitis and nasal allergy

Quantitative analysis of sialic acid and L-fucose in the patients with chronic sinusitis and nasal allergy

呼吸機能に及ぼす鼻呼吸障害の影響

The results of pulmonary function test of patients with nasal or paranasal diseases were analyzed to determine whether impairment of nasal breathing influences pulmonary function.Methods: lung volume, maximal expiratory flow volume and respiratory resistence through the mouth were measured in adults with normal nasal breathing (43 males, 46 females aged 20-66 years). Prediction equations in relation to age and height were obtaine from multiple linear regression curves. Data from patients with nasal or paranasal diseases were compared with those from normal subjects. The numbers distributed on each side of the normal regression line in relation to age were compared with the X2-test between the two groups. Those distributed beyond the range of ±2×standard deviation of each regression line were compared between the two groups. For evalation of the effect of treatment of sinusitis paired data obtained from pre- and post-operative tests were compared by the paired t-test.Results: Patients with chronic sinusitis, nasal allergy and atrophic rhinitis had more impairment of pulmonary function than did those with mechanical obstruction due to deviation of the nasal septum, hypertrophic rhinitis, etc.Among the former group nasal allergy caused more impairment in the items showing peripheral airway obstruction than did chronic sinusitis. The paired t-test comparing pre- and post-operative data in patients with sinusitis showed that VC (p<0.1%) and Vmax(p<0.1%) increased; V50(p<5%), V25(p<1%) V50/Ht(p<2%), and V25/Ht(P<1%) decreased; V50/V25 recovered towards the regression line; and RV (p<2%), FRC (p<5%), and respiratory resistence (p<1%) decreased to normal. Our results show that some parts of impaired pulmonary function can be restored to normal by the treatment of nasal diseases.

Elektronenmikroskopische Befunde bei allergischen Reaktionen der Nasenschleimhaut*

The fundamental morphologic aspects of acute and chronic allergic reactions, as well as endonasal polyps in allergic patients and disturbances of the autonomic nervous system were studied by means of electron microscopy. Characteristic changes are described which differ according to the stage of the allergic reactions; they are discussed in relation to the altered function of the allergic nasal mucosa.

Spontaneous DNA synthesis in tonsillar lymphocytes and its clinical implications.

Spontaneous DNA synthesis (SDS) in tonsillar lymphocytes was investigated in 58 cases by [3H]-thymidine incorporation under a certain culture condition without any mitogens. Tonsillar lymphocytes showed an extremely higher uptake of [3H]thymidine than peripheral blood lymphocytes. Cells exhibiting SDS were mainly B cells, but, however, they needed the helper functions of T cells and glass-adherent cells to synthesize DNA. SDS in tonsillar lymphocytes decreased with age and was lowest in the 21-30 year age group. SDS in cases with complications such as chronic sinusitis, nasal allergy or secretory otitis media was significantly higher than that in cases with no complications.

鼻粘膜血行動態の臨床的観察

The tissue blood flow of the nasal mucosa in normal subjects and patients with chronic rhinosinusitis, nasal allergy and vasomotor rhinitis was studied using the hydrogen clearance method. The hydrogen concentration was measured through platinum electrodes which were inserted into the inferior turbinate during inhalation of hydrogen in each of the subject groups. The blood flow was calculated from the equation proposed by Aukland, F=0.693/T1/2ml/min/g, where T1/2 is the half decay time of the hydrogen concentration.Statistically, no significant difference of the tissue blood flow in the inferior turbinate was found between each of the subject groups. Measurement was repeated at least twice and the values of the tissue blood flow in the first and second measurements were found to be very close.The tissue blood flow was almost the same if the position of the electrode is limited to within the anterior part of the inferior turbinate. There was no right-left difference in the inferior turbinate blood flow, except for the patients with nasal allergy.The flow increased during deep-breathing, and immediately after receiving cold stimulation on the hand except for the patients with nasal allergy whose flow decreased after receiving cold stimulation. The flow decreased when the subjects were given nasal spray of a vasoconstricting drug and after parforming breath-holding.The tissue blood flow was measured in patients with nasal allergy before and after nasal provocation by an allergen-containing paper disc. The flow decreased markedly in the tissue surrounding the allergen disc, whereas it increased in the tissue distant from the disc.Thus, it is concluded that the hydrogen clearance method is a useful tool for evaluating the blood flow of the nasal mucosa.

Kinetics of Immunoglobulins in Nasal Secretions of Chronic Sinusitis and Nasal Allergy

Chronic sinusitis is still one of the most prevalent nasal illnesses in Japan. The pathogenesis of this disease has not been fully understood yet. It has been shown that most of the IgA antibody secreted from the normal respiratory mucosa appeared to be of 11 S-IgA type. However, when the condition is inflammatory, change in the normal epithelial-capillary barrier results in a marked influx of serum immunoglobulins and other proteins, so that the kinetics of immunoglobulin classes in the external secretions changes remarkably and becomes more complicated.In the present study, we measured the concentration of immunoglobulins and other proteins in the nasal secretions from chronic sinusitis and nasal allergy, which represent the chronic nasal diseases of infectious and allergic inflammation, respectively. In the nasal allergy, the mean concentration of immunoglobulins was very similar to that of the previously-reported normal subjects. The mean concentrations of IgA, IgG, IgM and S-IgA in chronic sinusitis were significantly different from those in nasal allergy and the mean concentration of S-IgA in chronic sinusitis was almost three times as high as in nasal allergy. Comparing the concentration ratios of IgA/IgG and IgA/albumin with the normal in the serum, it was found that there was high local production of IgA in both diseases. However, the mean concentration of S-IgA and mean concentration ratio of S-IgA/total IgA in purulent secretion were not significantly different from the mucous secretion of chronic sinusitis and they varied considerably. In one-third of purulent secretions, the S-IgA/total IgA ratios were very low. α1-antitrypsin which is the main protease inhibitor in the serum had a significant correlation with the concentrations of DNA and IgG, but not with S-IgA. S-IgA was measured by the enzyme-linked immunosorbent assay and electroimmunodiffusion with the enzyme -labeled antibody method.In conclusion, it was found that there were different immunoglobulin kinetics in the noses of patients with chronic sinusitis and nasal allergy and immunoglobulin concentrations were different between purulent and mucous secretions of chronic sinusitis. Although the bulk of IgA and IgG was derived from serum, it was suggested that local synthesis of IgA and IgG was active in the nasal mucosa of chronic sinusitis.

Otolaryngological School Screening Examination

Otolaryngological school screening examination was carried out on 44, 932 students, 7 to 20 years of age, for eight consecutive years since 1973. They were examined by means of rhinoscopy by ENT specialists and 13 diseases were diagnosed. The results which were expressed in terms of prevalence rates were as follows:1: The prevalence rate of otitis media was 0-0.5% and remained unchanged for eight years.2: The rate of rhinitis was found to be 14.4%, the highest rate being in the 7-year-old children and the incidence decreased gradually with age to 3.0%, the lowest rate being in the 18-year-old students. The rate decreased gradually over the eight years. The prevalence rate of nasal allergy has increased remarkably in the eight years. The highest rate was 4.2% in the 15-year-old children. The rate of chronic sinusits has decreased slightly in the eight years. The highest rate was 5.0% in the 9-year-old children. However, no significant difference for the prevalence rate was found among the age groups for both chronic sinusitis and nasal allergy.3: The prevalence rate of palatine tonsillar hypertrophy was 18.9%, the highest rate being in the 7-year-old children and the incidence decreased with age to 2.0%, the lowest rate being in the 19-year-old students. The rate increased gradually over the eight years. The prevalence rates of chronic tonsillitis were highest in the 9 and 20-year-old groups being 12.1% and 12.5%, respectively. The lowest rate was in the 15-year-old children at 5.7%. The rate decreased in the eight years.Although the results were influenced by the individuality of the examiners and there were certain limitations of the examination which depended only on rhinoscopy, a general impression that infectious disease has decreased and allergic disorder has increased in the nose was confirmed in this study. Discussion on the general significance of school screening examination was also reported, including a system of otolaryngological school screening examination and the diseases to be screened for.

Ecological factors in learning disabilities.

Environmental causes of learning and behavior problems, as contrasted with genetic or congenital causes, are explored for the purpose of alerting the learning disabilities professional to those conditions for which remedial measures may be taken These environmental causes fall into five general categories chronic anxiety, malnutrition, toxicity, allergy, and electromagnetic radiation or technical pollution. Although remediation procedures will be different for each individual ecologic cause, recognition by the learning disabilities professional of ecologiceffected conditions will allow for recommendation and initiation of diagnostic procedures, which in turn could remediate the specific condition.

Desensitisation in a patient with chronic renal disease and severe allergy to allopurinol.

Desensitisation in a patient with chronic renal disease and severe allergy to allopurinol.

Effect of Broncasma Berna on Chronic Sinusitis and Nasal Allergy

Effect of Broncasma Berna on Chronic Sinusitis and Nasal Allergy

Denudation of basal membrane: an ultrastructural correlate of impaired membrane transport in protein losing gastroenteropathy ( PLGE )

Gastropathia hypertrophica gigantea MENETRIER in PLGE has only been reported 14 x in children; its etiology is unknown. A 5 y old boy showed vomiting of unusually viscous gastrie juice, severe anorexia during measles, generalized edema and hypoproteinemia of 3.0g%. No evidence for chronic malnutrition, allergy, renal, cardial or liver disease. 12.5% of the radioactivity(RA) of an iv dose of 51cr albumin appeared in a 72 h fecal collection(no <0.7%); 50.5% of RA appeared within 2 1/4 h in gastric juice with a protein output of ca 300 mg/h equivalent to an albumin loss of ca 8 g/d which exceeds the rate of albumin synthesis and thus explains hypoproteinemia. Pentagastrin iv adm. revealed a “sealing effect” for protein, Na, K, and Cl possibly of therapeutical importance. Electron microscopy revealed(1) numerous microvilli as a manifestation of increased resorptive processes and(2) a denudation of the basal membrane from their endothelial cells in the capillaries, thus manifold enlarging the interendothelial porus. This observation may well be of pathogenetic relevance.

Review of chronic secretory otitis and allergy.

Review of chronic secretory otitis and allergy.

A Brief Survey of Fungi as Allergen in Respiratory Allergic Patients by Intradermal Skin Sensitivity Test in Terai Area

The present survey was conducted to observe allergic effect of various fungi in patients of respiratory allergy of terai area.Terai area has humid, subtropical climate, warm in winter and hot in summer total of 96 patients were studied after full clinical examination. Age group of patients was 12 to 48 yrs and male female ratio was 3:2.About 12% patients had acute problem of breathlessness and rhinitis while rest were having chronic respiratory allergy. Intradermal test was performed to observe skin sensitivity.Rhizopus nigricans was found most offending fungal allergen (50%), Next to it was Aspergillus fumigates (30 %). Among other fungal allergens eg.Alternaria tenuis (28 %), Aspergillus flavus.(26 %),Curvularia sp.(24 %),Neurospora Sp.( 22 % ), Phoma sp. (18 % ),Fusarium solani (13 % ) ,Helminthosporium sp.(12 %) and Penicillium sp. (11 %) were found as common fungal allergens. Acrothecium sp, Aspergillus niger, Aspergillus tamari, Candida albicans, Cladosporium sp., Mucor sp., Nigrospora sp. and Trichoderma sp.etc were having allergenic effect in less than 10 % patients. About 12 % patients had not shown positive skin sensitivity test against any fungal allergen.

Dark Circles Under the Eyes

To the Editor:— I disagree with the explanation of Dark Circles Under the Eyes inThe Journal( 193 : 411, 1965) given by Dr. R. K. Winkelmann. In several publications and scientific exhibits, I have used the term shiners for this condition. Too often, these discolorations, particularly in children, are ascribed to chronic eyestrain, fatigue, or, in women at menarche, to menstruation. Since most of these eye shadows begin in early life, what transpires in the adult is often an extension of the process from childhood. In children this stigma is primarily caused by venous stasis as a result of perennial allergic rhinitis. Children with chronic nasal allergy develop these discolorations in the lower orbitopalpebral grooves from allergic edema of the mucous membranes of the nasal and paranasal cavities. The pressure of edematous mucous membranes on the venous network of the nasal and paranasal cavities interferes with normal drainage of

A controlled evaluation of two antihistamine compounds using nasal engorgement as an index of response

T HE evaluation of antihistamine compounds intended for the treatment of various allergic states in man is generally based, first, on the protection offered by the compound in animal studies (e.g., antagonism toward histamineinduced spasm in segments of guinea pig intestine, or inhibition of increased capillary permeability induced by injection of dextran) , and, second, on the subjective experiences of patients having chronic or seasonal allergies who have received the drug. While the first method is pharmacologically valuable and the data so derived are capable of fairly precise measurements, it is none the less somewhat distant to the situation encountered by the physician who undertakes the treatment of a patient with allergic rhinitis. The second approach, utilizing patients who have a seasonal pollinosis during the period of their difficulty, is unquestionably more germane to this particular aspect of antihistamine therapy, but, as usually performed, has many variables which cloud the true pharmacodynamics of the compound under study. Some of the problems encountered in such an investigation are described in an excellent report by Wahner and Peters.’ The method of study reported here represents an effort to create a controlled treatment situation which is similar to that which occurs in medical practice, but which will yield data subject to fewer unwanted variables.

Anamnesis, Sweat Electrolyte and Pulmonary Function Studies in Parents of Patients with Cystic Fibrosis of the Pancreas1

SUMMARYOne hundred and two parents of children with cystic fibrosis and 52 control parents were studied with regard to physical examination of the chest, personal and family history, sweat electrolytes and pulmonary function tests.The physical examination of the chest was negative in all parents.When the C.F. parents were compared with the control group, no significant differences could be found in the personal and family histories of chronic cough, allergy, gastrointestinal disorders (ulcer and cholelithiasis) and diabetes.The concentration of sodium, chloride, and potassium in the sweat (produced by iontophoresis) was similar in the two groups of parents.The pulmonary function tests (vital capacity, timed vital capacity, peak expiratory flow rate, maximal breathing capacity, and nitrogen washout) showed no significant differences between the two groups of parents.This study provides no evidence that cystic fibrosis is inherited as a dominant disease.By the methods used no particular characteristics were found which could differentiate the heterozygote carrier of cystic fibrosis from the non‐carrier.

Chronic allergy—crippler and killer of children

1. 1. Major allergy (particularly asthma, hay fever, and eczema) affects from 10 to 20 per cent of children. 2. 2. Asthma killed 6,677 persons of all ages in the United States in 1957, of which 139 were children under 5, and 233 were under 19. 3. 3. Acute poliomyelitis in this same period killed a total of 221 persons, of whom 53 were 5 years or under, and 119 were under 19 years. 4. 4. The economic cost, the sickness days, the impaired efficiency due to allergy in the school child can only be surmised from the fact that 1 out of 3 children receives medical attention for allergy. Medication for allergy accounts for a large proportion of all drugs prescribed. 5. 5. A sickness survey focused on allergic diseases and their antecedents, and the making of allergic diseases reportable to State Health Departments are two measures which should be instituted. 6. 6. There is a need for systematic individual medical programs and more numerous rehabilitation facilities for the child with chronic asthma. 7. 7. Rehabilitation groups should be made aware of the magnitude of this problem of chronic asthma and their aid enlisted. 8. 8. Education of patient, family, medical profession, and health organizations in the varied aspects of chronic allergy is urgently needed.

Urinary tract allergy.

In 1922 Duke 1 described the bladder symptoms arising from food allergy and felt that this cause should be considered in those urologic patients who exhibit little or no disease in the urinary tract. He listed frequent and painful urination, bladder tenesmus, a continuous severe pain over the bladder, and polyps from allergic edema as among these symptoms and stated that The condition may vary from slight discomfort to pain and tenesmus, which confines the patient to bed for months. Bladder allergy of long standing may be complicated by infection, in which case the symptoms of cystitis obscure the diagnosis. In patients having chronic bladder allergy no pathology may be found by internists, urologists, neurologists, roentgenologists, or pathologists, except hypersensitiveness to foods. Frequently the case may be misdiagnosed as cystitis, urethral carbuncle, misplaced uterus, or pelvic inflammatory disease. Treatment of such conditions often gives partial relief, but, as a rule,