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To clarify the effects of anti-allergic drugs on substance P (SP) and vasoactive intestinal peptide (VIP) levels in nasal secretions, we employed competitive enzyme-linked immunoassays to measure concentrations of those neuropeptides in nasal secretions from 40 patients with house dust nasal allergy before and after administration of azelastine and oxatomide. One mg of azelastine and 30 mg of oxatomide were administrated twice a day for 4 weeks. Mean values of SP concentrations and ratios of SP to total protein of the nasal allergy group were significantly higher than those of the control group (p < 0.002). The VIP/total protein ratio of the allergy group was also significantly higher than that of the control group, although the VIP concentration alone was not. Mean levels of SP and VIP from patients with severe symptoms were significantly higher than those of the control group (p < 0.05), although those values were not significantly different between patients with moderate symptoms and control subjects. Azelastine and oxatomide effectively reduced SP levels in nasal secretions (p < 0.005), but they did not significantly decrease VIP levels. The reduction of SP levels was significant in patients with excellent responses to those drugs (p < 0.005), but not in patients with poor responses. These findings suggest that SP and VIP levels in nasal secretions may reflect the clinical state of nasal allergy and be one of the better parameters available for evaluating the clinical efficacy of anti-allergic drugs against nasal allergy.

We studied 86 cases of orbital blowout fracture treated in our in-patient department between October 1981 and June 1999. Orbital floor fractures occurred in 51 cases , medial orbital wall fractures occurred in 12 cases, and both types occurred in 23 cases . Surgery was performed in 79 of these cases under general anesthesia.

4) Pelikan Z, Pelikan-Filipek M: Role of nasal allergy in chronic maxillary sinusitis-Diagnostic value of nasal challenge with allergen. J Allergy Clin Immunol 86: 484-491, 1991. 10) Kelly RW, Graham BJM, O'sullivan MJ: Measurement of PGE2 as the methyl oxime by radioimmunoassay using a novel lodinated label , Prostaglandins,

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Incisional biopsy for treatment of salivary gland neoplasm is absolutely contraindicated.We report here our experiences with 12 patients who had undergone prior incisional biopsy for parotid gland tumor. Seven of the twelve patients were diagnosed with malignant tumors, and five with benign pleomorphic adenomas.Among the malignancy cases, there were three patients with sequelae: local skin hyperemia, leakage of saliva, and incomplete local facial paresis. However, it was impossible to determine if these sequelae resulted from direct invasion of the malignant tumor or from the Incisional biopsy.In spite of the small size of the primary lesions, metastasis to the small neck lymph node were recognized.Furthermore, we recognized a high ratio of local recurrence in the malignant tumors that had been incised (3/12 cases) in comparison to that of malignant tumors with no prior incisional biopsy (1/14 cases). Even in benign tumors, incisional biopsy can cause tumor dissemination because of the presence of multiple daughter tumor cell nests, especially in pleomorphic adenomas.Radical treatment for parotid gland neoplasm involves complete surgical resection.For effective local control, incisional biopsy should be avoided.