No abstract

Thirty-three patients with histologically verified urticaria pigmentosa were studied for coexisting atopic disease by means of history, skin prick testing with five common inhalants and serological investigation for total IgE and specific IgE antibodies to five common inhalants. The prevalence of atopy in urticaria pigmentosa was similar to that observed in the normal Swiss population, both on the basis of history (7/33 = 21%) and of positive skin prick tests to common inhalants (12/33 = 36%). However, total serum IgE levels were significantly lower (geometric mean value 16.8 kU/l) than in a control group of 52 Swiss blood donors of comparable age and sex distribution (geometric mean value 43.0 kU/l, t = 2.93, P less than 0.005). Specific IgE antibodies to common inhalants were also observed less frequently in urticaria pigmentosa patients than in controls, although this difference was not statistically significant. Low total and specific IgE values in patients with urticaria pigmentosa may be explained by increased absorption of circulating IgE to abundant tissue mast cells.

The stylopharyngeal fascia may inhibit the distribution of opoids into the infratemporal fossa associated with a consecutive block of the mandibular nerve and lower the rate of pain relief.

The presented method is an optimized, strongly accepted teaching and training tool for teaching regional anesthesia.

Zusammenfassung: Der Bericht bezieht sich auf serologische Untersuchungen an 4223 Patienten. Die Ergebnisse von Komplementbindungsreaktion (KBR), indirektem Hämagglutinationstest (HAT) und Immunelektrophorese (IE) mit metabolischem und somatischem Antigen werden beschrieben. Pathognomonische Titer nach einem negativen Ergebnis sind nach ein bis vier Wochen zu erwarten. Die positiven Befunde persistieren in der Regel nicht, sondern nähern sich relativ rasch dem Normalbereich. Nach ein bis acht Wochen ist wieder mit negativen Befunden zu rechnen. Ein erneuter Anstieg des Titers oder der Anzahl der Banden kann eine erneute Bedrohung durch Candida anzeigen. KBR und HAT erreichen im Durchschnitt wesentlich früher ihren Maximalwert als die Immunelektrophorese (p <0,001). Im chi‐Quadrat‐Test auf Unabhängigkeit ergaben sich zwischen jeweils zwei Testen p‐Werte unter 0,0001. Die heuristische Konfigurationsfrequenzanalyse liefert Hinweise auf das Vorliegen von Typen und Anti‐Typen in der Candidaserologie. Eine Empfehlung bezüglich der Untersuchungshäufigkeit und des sinnvollen Einsatzes der einzelnen Methoden wird erarbeitet. Summary: Serum samples from 4223 patients were examined for the presence of antibodies to Candida albicans. Serological findings obtained by complement fixation reaction (CFR), indirect hemagglutination test (IHT) and Immunoelectrophoresis (IE) against cytoplasmatic extracts and oidiomycin were evaluated. Pathognomonic titers can be expected one to four weeks after normal findings. Elevated titers usually do not persist. A decrease in antibody levels from initially high titers to insignificant range is found after one to eight weeks. Antibody levels rising again are considered diagnostically significant. CFR and IHT in general require less time to develop their peak value than immunoelectrophoresis (p <0.001). Chi‐square tests for independence in 2 × 2‐contingency tables reveal values of p <0.0001. The heuristic configural frequency analysis is used as a statistical tool for defining types in Candida serology. Types are defined as patterns of laboratory findings occuring more frequently than may be expected under the assumption of complete independence of the respective tests. Single determinations are inconclusive; use and value of serologic tests, particulary when used in combination and repeatedly, are discussed.