Urethral stricture as unusual complications of Wegener's granulomatosis.

A patient with Wegener's granulomatosis is reported. The diagnosis was confirmed by parotid gland biopsy. The patient responded to treatment with cyclophosphamide and prednisone. After many years, urethral stricture and subglottic stenosis developed and responded satisfactorily to surgery.

In vitro and in vivo effect of salbutamol on histamine release from human basophils.

The effect of salbutamol, a selective beta 2-adrenergic agonist, on immunological release of histamine from leukocytes isolated from blood of 14 allergic, asthmatic patients, was investigated after in vivo or in vitro drug administration. Simultaneously, the effect of this drug on peak expiratory flow rate (PEFR) was estimated. Histamine was assayed by the single isotope-enzymatic method. Obtained results have confirmed that salbutamol is a rather poor inhibitor of histamine release from basophils. Although both administered salbutamol doses (0.5 or 1 mg, i.v.) significantly increased PEFR (p less than 0.01), inhibitory effect on histamine release by allergen was seen only after higher dose administration in vivo (p less than 0.01 against control). Similarly, a small but significant decrease in histamine release by both concanavalin A (by 20%, p less than 0.01) and allergen (by 30%, p less than 0.025) was seen in vitro after incubation of leukocytes with 8 x 10(-6) mol/l salbutamol, whereas 4 x 10(-7) mol/l salbutamol was without effect.

A steroid-sparing effect of ketotifen in steroid dependent asthmatics.

The steroid-sparing effect of ketotifen was studied in 30 steroid-dependent patients with atopic asthma with a mean age of 44 years, using a protocol of 3 consecutive periods of 3 months each. In the first period the average daily consumption of steroids was established. During the second period the patients were given ketotifen, 2 mg daily, which was withdrawn in the third period. The mean daily steroid consumption (prednisolone equivalents) was 11.08 mg in the first period, 3.13 mg in the second and 5.12 mg in the third. During ketotifen treatment steroids could be withdrawn in 12 patients and reduced in another 14 without any deterioration of their clinical state or increase of consumption of symptomatic antiasthmatic drugs.

Assessment of adrenocortical function in asthmatic patients on long-term triamcinolone acetonide treatment.

The adrenocortical function of 48 adult asthmatic patients on long-term corticoid therapy was studied. All were treated with triamcinolone acetonide (TA) for from two to six (average 3.5 years). The adrenocortical function was assessed using a short Synacthen test as a screening procedure and a five-hour Synacthen test for TA exclusively treated patients with abnormal response in the short test. Among patients on long-term TA were nine with abnormally short Synacthen tests. The five-hour test revealed six abnormal responses (12% of the entire group of TA treated patients). Contrary to previously expressed opinions the authors feel that TA long-term treatment only occasionally causes steady adrenal suppression.