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Information on pollen dispersion is useful for members of the general public with allergies.We measured the Japanese cedar and cypress pollen counts by two methods, a Durham sampler and a real-time pollen counter (KH-3000), in Kawachinagano City, located in the south-eastern part of Osaka.The results were as follows: There were close correlations between the findings of the Durham pollen counter and the KH-3000 in March and April of 2003.The airborne pollen observed with the KH-3000 did not correlate with the average temperature or average wind velocity of March and April.There was more airborne pollen dispersion when the wind blew from west-south west and north east.We concluded that local information about pollen dispersion is important for self-care.

Several reports indicate that the severity of perennial allergic rhinitis is related to levels of dust-mite allergens. In this study, the levels of dust-mite allergens measured in the homes of 13 people with allergic rhinitis and 10 healthy volunteers. Dust specimens were collected with a vacuum cleaner and analyzed for the presence of major mite allergens (Der 1=Der p1+Der f1, Der 2=Der p2+Der f2) by using ELISA. Levels of Der 1 were higher in bedclothes, in bedrooms, and on family room floors. There were no differences between the homes of the 13 people with allergic rhinitis and the 10 healthy volunteers. No association was found between levels of dust-mite allergens and the severity of nasal symptoms. Although the levels of mite allergens increased in most of homes 2 months after cleaning, there was an insignificant tendency for improvement in nasal symptoms in homes with decreased levels 2 months after cleaning.

It is important to determine the allergen for treatment and prevention in allergic diseases, especially pollinosis. However, few patients have their specific allergen determined prior to treatment. In this study, we investigated the positive rate of specific IgE in 299 patients with suspected Japanese cedar pollinosis. Ten allergens were tested using CAP-RAST in 299 subjects consisting of 175 males and 124 females who visited the OCROM clinic (Suita city). The positive rate was 78.9% for Japanese cedar, 52.5% for D1, 50.8% for D2, 50.5% for HD1, 48.5% for Japanese cypress and 44.1% for orchard grass. About 60% of the patients who were positive for Japanese cedar also showed positive for Japanese cypress. However, no patients were positive for Japanese cypress and negative for Japanese cedar. There were no correlations between positivity rates and age for Japanese cedar. However, in HD1, the positive rate in younger patients was higher than in older patients. The numbers of simultaneously positive allergens was 4.5 in patients under 20 and gradually decreased according to age. It was very interesting that 2 patients were positive only for birch pollen and in these cases, it was very difficult to decide whether the patients had Japanese cedar pollinosis. Based on these results, we suggest that it is necessary to determine the specific allergen before treatment or prevention.

The clinical efficacy and safety of 200 μg/day (100μg b. i. d) of mometasone furoate nasal spray (MFNS) administered for 2 weeks was evaluated by comparison with a low dose of MFNS of 50μg/day (50μg o. d.) using the envelope-method in a total of 65 patients with Japanese cedarpollenosis.The pollen counts for Japanese cedar in 1995 were extremely high in the Kansai district. About 5, 000 counts/cmz was confirmed in and around Osaka.In the analysis of final overall improvement, marked or moderate improvement was observed in 76.2% (16/21) and 20.8% (5/24) of patients receiving MFNS 200μg/day and 50μg/day, respectively. The difference in efficacy between the two dosage groups was confirmed independently of timing of the initiation of administration. In the analysis of overall safety, high safety was observed with both treatments. The above results suggest that 200μg/day of MFNS can be considered the recommended dose for the treatment of Japanese cedar pollenosis.

The clinical usefulness of 200μg/day of mometasone furoate (MF) nasal spray administered over 2 weeks was compared against 31.2μg/day of disodium cromoglycate (DSCG) using a telephone nominating method in a total of 69 patients with Japanese cedar pollenosis.The Japanese cedar pollen count in 1996 was extremely low, apporoximately 1/10-4/20 of that in 1995. On an analysis of the overall improvement, marked or moderate improvement was observed in 69.0% (20/29) and 20.7% (6/29) of patients receiving MF and DSCG, respectively; this was statistically different. MF also showed significantly superior efficacy over DSCG in almost all subjective and objective nasal symptoms. A significant correlation between the total nasal symptom scores based on three main symptoms of nasal allergy and overall improvement judged by an independent investigator was confirmed. The proper discriminant rate by discriminant analysis was high at 93.1%. On an analysis of the overall safety, good safety was observed for both treatment groups. The above results suggest that MF is highly useful in the treatment of Japanese cedar pollenosis.

A clinical study of 220 patients with grass pollen allergy who were treated at our hospital from April to June in 1993 was performed. The patients (66 males, 154 females) ranged in age from 4 to 71 years old with a mean age of 35.0 years. Patients with grass pollen allergy had an earlier onset than those with cedar pollinosis. Of patients with grass pollen allergy, 60.7% were found to be hypersensitive to Japanese cedar pollen, and 52.0% were found to be hypersensitive to cypress pollen by CAP-RAST. Throat symptoms were observed more often in patients with grass pollen allergy than in those with cedar pollinosis.

The saccharine test was used to measure nasal mucociliary clearance in 71 patients with nasal allergy (56 without and 15 with chronic sinusitis), 12 patients with asthma (7 without and 5 with chronic sinusitis) and 7 patients with aspirin-induced asthma. The results were compared with those of a control group of 15 healthy subjects. The saccharine time (ST) in patients with nasal allergy without chronic sinusitis (16.9±9.9min) and in those with asthma without chronic sinusitis (20.1±9.4min) did not differ not significantly from that in the healthy subjects (16.3±5.3mm). But the ST in patients with nasal allergy and chronic sinusitis (37.6±22.9min) and in those with asthma and chronic sinusitis (57.0±6.7min) was significantry longr than in the controls (p

A 63-year-old woman with multiple disturbances of the cranial nerves is reported. She initially complained of bilateral hearing loss and otorrhea, followed by right facial palsy and vertigo and was hospitalized on August 25, 1983. Despite steroid therapy, her condition deteriorated and finally complete bilateral deafness and complete bilateral facial palsy developed.Histologial examination of the mastoid mucosa, obtained by exploratory tympanotomies in both ears, showed non-specific inflammation. Noteworthy findings or laboratory examinations were extremely high levels of ESR and CRP, positive RA test, and negative tuberculin test.Tracheotomy was performed because of recurrent bilateral nerve palsy. Scleritis occurred in March, 1984, and the disturbances of eye movement, ptosis and atrophy of tongue developed in September, 1984. Long-term steroid therapy did not improve cranial palsy. There were no neurological signs such as pathological reflex in the limbs, involuntary movement or meningeal irritation symptom. There were no remarkable findings on CT or MRI.Although treatment by a local hospital continued, the III, IV, VI, VII, VIII, X and XII cranial nerves remained paralyzed. She finally died of systemic weakness in March, 1989.This was a rare case that began with bilateral otitis media and proceeding to paralysis of initially occurred and cranial nerves in order of VII, VIII, X, XII, III, IV and VI nerves. The background of this case included systemic vascular disease, especially Cogan's syndrome, because of otologic and ocular symptoms and multiple disturbances of the cranial nerves.

Adrenaline, ipratropium or fenoterol was applied to one nasal cavity of patients with nasal allergy. The nasal mucosal blood volume (IHb) of both sides was measured with a tissue spectrum analyzer (TS-200, Sumitomo Electric Co. Ltd.) before and 5 min. after the application of the drugs.I) Unilateral application of adrenaline (0.01mg/ml, 0.12ml) decreased the IHb on the ipsilateral side but caused no change of the IHb on the contralateral side.II) Unilateral application of 20μg of ipratropium induced no change of IHb on either side.III) Unilateral application of 0.2mg or 0.4mg of fenoterol induced no change of IHb on either side.IV) Fenoterol (0.2mg) caused no significant difference in the IHb of patients with or without symptoms.V) In the patients treated with fenoterol (0.2mg), there was no significant difference of IHb between those who always used topical steroid and those who did not.These results suggest that the nasal mucosal capacitance vessels of patients with nasal allergy respond more to a-adrenergic stimulants than to β-adrenergic stimulants or anticholinergic agents.

We report a case of ASNHL (autoimmune sensorineural hearing loss) with systemic symptoms. The patient was a 64-year old female who consulted us with complaints of bilateral hearing loss and left tinnitus. Later, she had cranial polyneuropathy (L: V VII VIII, R: VIII XII), diabetes insipidus, headache and fever. Her blood sedimentation rate, CRP and γ-globulin were increased. Antinuclear antibodies and antihypophysis antibodies were found in her serum. Her general condition and hearing level were improved by steroid and cyclophosphamide therapy. Autoimmune vasculitis was suspected, but histopathological studies of granulation tissue around the left stapes and left superficial temporal artery were not specific. Steroid therapy is being continued.

The etiology of Meniere's disease has been investigated by various methods, but is still not clear. It is thought that one aspect of the pathology is concerned with allergy, especially food allergy. In this study we examined the correlation between Meniere's disease and type I allergy using the MAST system. MAST is a new system for detecting allergen-specific IgE antibodies. Multiple antigen can be examined simultaneously and quickly by this method. We could find no relationship between Meniere's disease and type I allergy, especially food allergy. If food allergy is involved in the etiology, it may be a different type of allergy.

Although nasal mucosal hemodynamics in nasal allergy has been studied by various methods, it is still obscure. Using a tissue spectrum analyzer, we measured ISO2 and IHb in the nasal mucosa of patients with nasal allergy. ISO2 and IHbindicate O2 saturation in hemoglobin and tissue blood volume, respectively.i) In general, little difference in ISO2 or IHb was found beween patients with symptoms and patients without symptoms.ii) IHb in patients with perennial nasal allergy seemed to decrease when they had symptoms. On the other hand, IHb in patients with seasonal nasal allergy seemed to increase when they had symptoms.iii) In three patients with Japanese cedar pollinosis, IHb was increased during the season and was decreased at other times.

As sexual habits are becoming more diversified, oral sex is increasingly frequent, so otorhinolaryngologists are seeing more cases of STD.Our patient was a 25-year-old single male with the chief complaint of pain in the lower lip. The first diagnosis was stomatitis, but the lesion failed to improve.Suspecting STD, we reexamined the patient. The serological tests for syphilis were positive, and penicillin was administered orally for 2 weeks. Notable improvement was achieved. The patient was questioned about the route of infection and confessed to engaging in kissing and fellatio.

It has been reported that histamine could increase the cyclic-AMP level via the H2-receptors present on the basophilic cells and that H2-receptors might be responsible for the negative feedback control of mediator release. Therefore, treatment with H2-blockers might be contraindicated in allergic patients. It has already been reported that Cimetidine increases bronchial sensitivity.In this study, nasal reactions to Cimetidine and Famotidine treatment were evaluated in 10 healthy adults by the histamine nasal provocation test (HPT) in a double-blind, cross-over trial. The HPT was conducted before treatment and 3 and 7 days after the start of treatment.The nasal reaction to histamine was not significantly changed by the administration of Famotidine. However, a moderate increase in nasal sensitivity was noted after 7 days of Cimetidine treatment. Nasal sensitivity after 7 days of Cimetidine treatment was significantly greater than that after Famotidine treatment.We conclude that in patients with nasal allergy and peptic ulcer Famotidine is preferable to Cimetidine for the treatment of digestive tract disorders.

Facial paralysis caused by chickinpox are rare. Two cases of facial paralysis associated with varicella were described.First case, a 5-year-old girl, complained of immobility of right facial muscle on Feb. 6, 1979. Three days later, she developed typical varicella. Laboratory studies revealed no abnormalities except for an elevated anti varicella-zoster virus (VZV) antibody levels in the serum. Anti VZV antibody titers were measured by immune adherence hemagglutination test (IAHA). The serum IAHA titers for VZV were 1:128 (Feb. 14) and 1:128 (March 5). Complete recovery occured five weeks after the onset.Second case, a 5-year-old boy, had a skin rash and diagnosed as varicella on April 5, 1979. On May 17, he noticed a weakness of the right facial muscle. No other neurological abnormalities were observed. About two weeks later, mumps occured. The serum IAHA titers for VZV were 1:64 (May 23) and 1:128 (June 18) and the mumps virus antibody titers were 1

The clinical effects of MS-A nebulizer therapy were evaluated in 23 patients with nasal hypersensitivity: 13 with nasal allergy (NA) and 10 with vasomotor rhinitis (VMR). The patients received 2 ampules once or twice a week for a total of 8 times.The efficacy rate was 61.5% for NA and 60.0% for VMR. The rate of improvement in nasal congestion was 46.2% for NA and 60.0% for VMR. Rhinorrhea decreased in 61.5% of these with NA and 70.0% of those with VMR. Percentages of patients showing a decrease in the number of sneezing attacks was 61.5% for NA and 57.1% for VMR. In half of the patients, the effects of MS-A nebulizer therapy were noted by the 5th application. There was no side effect observed in any subject.MS-A nebulizer therapy was considered to be effective for the treatment of nasal hypersensitivity.

Asthma, aspirin intolerance and nasal polyps form the triad of aspirin-induced asthma (AIA). We report two cases of AIA in which polypectomy was performed.Case 1 was a 56 y. o. female. She had had asthma attacks for 10 years, and had noted that they were precipitated or aggravated by aspirin ingestion. She also had large polyps in both nasal cavities, and sometimes had symptoms of nasal allergy. She was treated with corticosteroids, theophilline and β-stimulants. There was an eosinophilia of 8% in the peripheral blood, and the serum IgE was elevated. RAST were positive for dermatophagoides pteronnysinus (D1). She underwent polypectomy on November 30, 1984. An asthma attack occurred during the operation, persumably due to 4% Xylocaine which contains parabens and dyes. Histological examination showed infiltration of eosinophils in the polyps.Case 2 was a 30 y. o. male who had complained of sneezing and watery rhinorrhea for 4 years. For 2 years, he had also had asthma attacks precipitated or aggravated by aspirin or indomethacin. Eosinophils in the peripheral blood were greatly elevated 31%. Skin tests were positive for house dust, ragweed and Japanese cedar, but all RAST tests were negative. Serum IgE was normal. He underwent nasal polypectomy on March 8, 1985. His polyps also showed infiltration of eosinophils as in Case 1.AIA is not a rare disease in Japan. The study of eosinophils in nasal polyps and peripheral blood may be useful in the elucidation of the pathogenesis of AIA.

The end point of intracutaneus test titration with a number of allergens was correlated with the RAST score in 76 patients with nasal allergy. The duration of the disease was also correlated with RAST scores and various other data.In the case of house dust allergy, the end point of intracutaneus test titration and the duration of the disease showed a significant correlation with the degree of sensitivity to the intracutaneus tests and the RAST scores.In the case of cedar-pollen allergy, the end point of intracutaneus test titration was not correlated with the RAST score, but a positive correlation was noted between the duration of the disease and the degree of sensitivity to the intracutaneus test.It was concluded that RAST scores and the degree of sensitivity to intracutaneus tests can be used in determining the initial concentration of house dust solutions for desensitization therapy.

The therapeutic effects and safety of AA-673 tablets were studied in 54 patients with perennial nasal allergy refractory to other oral antiallergic agents.The patients were prescribed a 50 mg tablet of AA-673 three times daily for 4 weeks.Evaluation of the final global improvement revealed “moderate improvement or better” in 23% of the patients, and “slight improvement or better” in 65%.In comparison between groups of the pretreated agents, the evaluation suggested difference between each groups.Side effects were observed in 4 patients (7.4%), but they were mild and transient.AA-673 tablets were considered to be useful for patients with perennial nasal allergy refractory to other oral antiallergic agents.

The effect of HG (Histamine-Gammaglobulin-Conjugate), which has been used to treat allergic rhinitis, was studied in actively sensitized Hartley guinea pigs weighing 200-300g.After a sensitizing application of 10% TDI (toluene diisocyanate) to the noses of guinea pigs, we confirmed sensitization by applying 5% TDI. Eight sensitized and seven nonsensitized guinea pigs received subcutaneous injections of HG or saline.Symptom scores were recorded, and the therapeutic effect was assessed. Furthermore, after challenge of the animals, the histamine content of the blood, the turbinates and the lungs was determined after sacrifice under general anesthesia with pentobarbital sodium.Five of the seven treated with HG showed a good response, while none of those injected with saline improved. The group treated with HG had a higher content of histamine in the turbinates and the lungs, but a lower blood level than the control group.This experiment on model animals with nasal allergy verified the safety and therapeutic effectiveness of HG. The tissue histamine content suggested that HG inhibits histamine release from mast cells.

Asthma, aspirin intolerance and nasal polyps form the triad of aspirin-induced asthma (AIA). Eight patients with AIA and nasal polyps, 2 males and 6 females, were seen in our clinic from 1984 to 1986. We examined the relationship between nasal polyps and sinusitis diagnosed by nasal X-ray in AIA with nasal polyps. Four patients had moderate to large polyps and moderate to severe sinusitis, while four mild or no sinusitis regardless of nasal polyps. Hi.stological examination of the nasal polyps of 4 patients showed marked infiltration with eosinophils. In addition, marked peripheral blood eosinophilia was seen in 6 of 7 patients; the highest eosinophil count was 31%. However, only one patient was atopic with a high IgE level and positive skin test. Thus, nasal X-ray examination and the study of eosinophils in nasal polyps and peripheral blood may be useful in diagnosis of AIA.

1. Eighteen Patients with nasal hypersensitivity, 9 with nasal allergy and 9 with vasomotor rhinitis were treated with MS-Antigen 40 (MS-A) for more than one year.2. The overall improvement rates after one year of MS-A treatment were 66.7% in cases of nasal allergy and 88.9% in cases of vasomotor rhinitis.3. The greater the total dose, the better was the clinical effect.4. The effect of MS-A was noted within 3 months in many cases.5. The continuation of MS-A injections was necessary every 2 to 4 weeks for the maintenance of the clinical effect.6. The mechanism of action of this drug is not clear, but it is probably associated with the stabilization of mast cells.

Relapsing polychondritis (RP) is a systemic disorder characterized by recurrent inflammation and degeneration of cartilage. A 49-year-old woman was admitted to our hospital with bilateral hearing loss and tinnitus. Physical examination revealed saddle nose and congestion of bulbar conjunctiva. Both tympanic membranes and external auditory canals were hyperemic. Her sedimentation rate was 30mm/hr and WBC 8370. Anti-nuclear antibody and anti-cartilage antibody were positive. The OKT4 OKT8 ratio in the peripheral blood was 4.17. Audiograms revealed both sensori-neural and conductive impairment. Biopsies of the nasal septum showed degeneration of cartilage, fibrosis and mononuclear cell infiltrates. Treatment with 1000mg Solu-Medrol for three days (every other day) resulted in dramatic improvement in hearing and tinnitus after a few days of treatment, suggesting excellent prospects of pulse therapy of steroid hormone in the treatment of RP.

Autonomic nervous function was studied in patients with nasal hyperreactivity (allergic rhinitis and vasomotor rhinitis). The R-R intervals in the EGG were calculated and Aschner's test and Shellong's test were performed as autonomic nervous function tests. The results of these tests were compared with those of normal subjects or patients with other diseases (Menier's disease, discomfort of the throat). The coefficient of variation of R-R intervals (R-Rcv), showed the nasal hyperreactive group did not differ from the other three groups. In patients with nasal allergy the onset of hyperreactive symptoms correlated positively with low level R-Rcv. Aschner's test and Shellong's test results in the nasal huperreactive group showed no abnormality of parasympathetic function, but sympathetic activity was greater than in the normal group. The onset of hyperreactive symptoms in patients with nasal allergy appear to be closely related to increased generalized sympathetic activity.