F. Di Berardino

Grass transcutaneous immunotherapy in children with seasonal rhinoconjunctivitis

has reported on allergic reactions induced by a peripherally acting cough suppressant. The mechanism of the codeine-induced allergic reaction was explained as an immediate response of mast cells that were activated by codeine directly to release histamine (6). Based on these findings, levodropropizine induces an anaphylactic reaction via a direct HR mechanism. In conclusion, we report a severe anaphylactic reaction caused by levodropropizine that was mediated by direct HR effects from basophils. This study was supported by a Korea University Grant.

MR Imaging in Sudden Sensorineural Hearing Loss. Time to Talk

SUMMARY: Sudden sensorineural hearing loss is defined as acute hearing loss of the sensorineural type of at least 30 dB over 3 contiguous frequencies that occurs within a 72-hour period. Although many different causative factors have been proposed, sudden sensorineural hearing loss is still considered “idiopathic” in 71%–85% of cases, and treatments are empiric, not based on etiology. MR imaging implemented with a 3D FLAIR sequence has provided new insights into the etiology of sudden sensorineural hearing loss. Herein, we review the current management trends for patients with sudden sensorineural hearing loss, from the initial clinical diagnosis to therapeutic strategies and diagnostic work-up. We focused primarily on MR imaging assessment and discuss the relevance that MR imaging findings might have for patient management, pointing out different perspectives for future clinical research.

Flat Panel Angiography in the Cross-Sectional Imaging of the Temporal Bone: Assessment of Image Quality and Radiation Dose Compared with a 64-Section Multisection CT Scanner

BACKGROUND AND PURPOSE: Cross-sectional imaging of the temporal bone is challenging because of the complexity and small dimensions of the anatomic structures. We evaluated the role of flat panel angiography in the cross-sectional imaging of the temporal bone by comparing its image quality and radiation dose with a 64-section multisection CT scanner. MATERIALS AND METHODS: We retrospectively collected 29 multisection CT and 29 flat panel angiography images of normal whole-head temporal bones. Image quality was assessed by 2 neuroradiologists, who rated the visualization of 30 anatomic structures with a 3-point ordinal scale. The radiation dose was assessed with an anthropomorphic phantom. RESULTS: Flat panel angiography showed better image quality than multisection CT in depicting the anterior and posterior crura of the stapes, the footplate of the stapes, the stapedius muscle, and the anterior ligament of the malleus (P < .05). In contrast, multisection CT showed better image quality than flat panel angiography in assessing the tympanic membrane, the bone marrow of the malleus and incus, the tendon of the tensor tympani, the interscalar septum, and the modiolus of the cochlea (P < .05). Flat panel angiography had a significantly higher overall image quality rating than multisection CT (P = .035). A reduction of the effective dose of approximately 40% was demonstrated for flat panel angiography compared with multisection CT. CONCLUSIONS: Flat panel angiography shows strengths and weaknesses compared with multisection CT. It is more susceptible to artifacts, but due to the higher spatial resolution, it shows equal or higher image quality in assessing some bony structures of diagnostic interest. The lower radiation dose is an additional advantage of flat panel angiography.

A case of contact dermatitis from jojoba

A 79-year-old lady presented with a 2-month history of soreness and swelling of her upper and lower lips, associated with dryness, cracking and ulceration. Prior to this, she had been intermittently applying Vaseline, her own lipsticks and Blistex (a brand of lip slave). Patch tests were performed to the departmental standard series (based on the European standard series with a few additional allergens), a hand and face series, several mint products and 3 of her own lip cosmetics including Blistex. Patch and photopatch tests were also performed to 2 sunscreens chemicals identified as constituents of the lip cosmetics (oxybenzone and ethylhexylmethoxycinnamate). The patch tests were entirely negative. The photopatch tests (UVA 5 J/cm) revealed photoallergy to oxybenzone (benzophenone-3) with no reaction at the non-irradiated site. The Blistex contained oxybenzone, which she was advised to stop using, as well as avoiding all other cosmetics containing this UV filter. At follow-up, 4 months later, the cheilitis had resolved. Discussion