As a part of Goshiki Health Study, we investigated the distribution of serum IgE in 670 school children aged 10 to 14 years and analyzed its relation to allergic diseases.
Serum IgE showed a log-normal distribution, and the geometric mean and 95% range were 140IU/ml and 8 to 2, 570IU/ml for boys, and 112IU/ml and 6 to 1, 950IU/ml for girls, respectively. Boys had asignifi cantly higher IgE level than girls (p<0.05). Schoolchildren with the medical history of allergic diseases showed higher serum IgE than those without them. The prevalence of allergic diseases was strongly related to the serum IgE level, and the relative risk of allergy of the schoolchildren with high serum IgE (≥500IU/ml) was 6.17 for boys and 4.45 for girls, as the risk of those with the low serum IgE (<30IU/ml) was 1.0.
These results indicate a close relationship between serum IgE and allergic diatheses and suggest that serum IgE is a predictive measure of allergic diseases.

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Seven cases of children who had seizures or neurologic symptoms during theophylline administration were reported. One patient was treated with overdose theophylline preparation, but the rest of the patients were treated with appropriate doses. These patients were classified into two cases of encephalopathy, one case of induced epileptic seizure, two cases of induced febrile convulsion, and two cases of theophylline intoxication. The theophylline-associated seizures shared tendencies to have long duration and to be refractory to various anticonvulsants. One of two patients with encephalopathy had an unilateral brain damage, the other patient had a long stupor status. The patients with theophylline intoxication had many symptoms prior to seizures including vomiting, sleep disturbance and headache, whereas other cases had few preceding symptoms. Theophylline administration to the patients with a history of seizures should be carefully done, because it has a possibility to develop seizures even under the toxic level. Furthermore, to avoid theophylline intoxication, it is important to pay attention to various preceding symptoms.

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In case of infants, it has been known that residence time in the digestive tract is shortier than in case of adults with the result that sustained-release preparations are not necessarily absorbed a hundred percent and that a serum concentration varies with the type of preparations and patient's conditions, thus causing a change in AUC (area under the curve). However, while theophylline absorption rates have so far been determined on the basis of determination of a total amount of metabolites in urine or determination of a change of its serum concentration.
When a quotient obtained by dividing an amount of theophylline excreted feces by a dose of theophylline was taken as a theophylline excretion rate in feces, the cxcretion rate was 1% or below for aminophylline, 2% or below for Theolong (excluding onf case of bad fecal nature), 3% of below for The odor, 4% or below for Slobid (excluding 3 cases), and 12% at a maximum.
A theophylline concentration in feces was 7.0±9.57μg/g after administration of aminophylline, 26.8±42.5μg/g after administration of Theolong, 19.9±12.3μg/g after administration of Theodur, and 54.3±43.4μg/g (Mean±SD) after administration of Slobid.
The above has made it known that sustained-release theophylline preparations are not necessarily absorbed hundred percent and that there is a difference in absorption between types of preparations. In determination of a serum theophylline levels, especially when said concentration is low, in addition to a case of a large clearance and is a case in which absorption is not sufficient due to too short residence time in the intestines and bioavailability is low.

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The efficacy of additional beclomethasone dipropionate to a conventional therapy in the treatment of acute asthma attack in childhood was evaluated. The mean dose of BDP was 8.7±2.6μg/kg/day, taken 3 times a day through a spacer. BDI did not hasten improvement of wheezes and PEFR. It was not demonstrated that BDI had acute effect to get early recovery of acute asthma attacks.

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When I proposed the standard values of serum IgE levels in children before, supposed values were used in infants, since serum IgE levels in low range could not be measured at that time. As we were able to determine the IgE value in low range using Pharmacia RIA or LUMIWARD assay system, I tried to evaluate the formerly proposed standard IgE values in infancy.
However, the standard values of serum IgE levels in infancy could not be evaluated from the distribution of IgE levels because of the small number of “low IgE infants”. A part of these infants were then monitord for the changes of IgE levels up to over 1 year of age.
As the results, the formerly proposed standard IgE values were proved to be appropriate even in infancy.

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This study was carried out to prevent the adverse effects to measles vaccine in children with food allergy.
Intradermal skin tests using of diluted measles vaccine were performed in 156 children before vaccination.
The children were divided into two groups: 131 were treated with elimination diet of eggs and/or cow's milk (elimination group) and 25 were treated without elimination diet (non-elimination group).
We examined the association between the positive reaction rate of intradermal skin test (positive rate) and the elimination diet, and examined the correlation between the positive rate and the severity of atopic dermatitis (AD).
The results were as follows:
1) positive rate in elimination group was significantly higher than that in non-elimination group (P<0.01).
2) positive rate was significantly higher in children who had eliminated strictly (P<0.01).
3) positive rate had association with severity of AD at first examination (P<0.05), and had no association at vaccination.
For the children with the positive reaction of intradermal skin test (positive group), we vaccinated with a 1/10 dose of vaccine. We checked the safety and measured the measles antibody titers at 8 weeks after vaccination.
The results were as follows:
4) We observed the adverse effects in all 27 cases: all were slight, none was serious.
5) The measles antibody titers were positive in all 27 cases.
According to these results, we must pay careful attention to the measles vaccination in children with food allergy. We consider it essential that we perform intradermal skin test using measles vaccine on children with food allergy before vaccination and decide on the safe dosage of vaccine.

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The present study was undertaken to examine the clinical usefulness of the optical isomers of isoproterenol by their bronchodilating effect in children with asthmatic attack and their heart rate increasing effect in healthy volunteers. Thirty patients with asthmatic attack were randomly assigned to inhale l-isoproterenol or dl-isomer which contained the same dose of l-isoproterenol. The pulmonary functions were measured in both groups before and after inhalation. In the group inhaled l-isoproterenol, mean% of forced expired volume in one second (%FEV_1.0) increased significantly from 37.5% to 54.3%. We observed also significant increase in mean %FEV_1.0 from 37.5% to 60.8% in the group inhaled dl-isomer. There was no significant difference in improvement of mean %FEV_1.0 between both groups.
Concerning heart rate increasing effects, we measured changes in heart rate by electrocardiogram in thirteen healthy volunteers before and after inhalations of l-isoproterenol or dl-isoproterenol or saline.
Although both l-isoproterenol and dl-isomer significantly increased heart rate compared to saline from 1 minute after begining of inhalation to 3 minutes after completion, there was no significant difference in their effects on heart rate.
These findings suggest that l-isoproterenol and dl-isomer contained dose of l-isomer have similar clinical benefit for continuous inhalation therapy, because both induced same degree of bronchodilatation and of stimulation of heart.

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We studied effects of cell wall constituents of Staphylococcus aureus, peptideglycan (PG) and N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP: muramyl didpeptide) on IL-4 induced IgE synthesis, interleukin 6 (IL-6) and interferon γ (IFN γ) production in peripheral blood mononuclear cells (PBMCs) from patients with atopic dermatitis (AD). PBMCs from patients with AD whose IL-4 induced IgE synthesis was low (<2U/ml) showed an elevated IgE production by the addition of PG or MDP (P<0.45), while PMBCs from patients with AD whose IL-4 induced IgE synthesis was high (≥2U/ml) showed a suppressed IgE synthesis by the addition of PG, whereas IgE synthesis was enhanced with MDP. But PBMCs from healthy children showed no significant changes in IgE synthesis when PG or MDP were added. Both PBMCs from AD and healthy children showed mild increase in IL-6 generation by the addition of PG or MDP. The IFN-γ generated from PBMCs showed a significant increase (P<0.05) by the addition of PG, and not by the addition of MDP in both healthy and AD groups.
These results indicated that Staphylococcal cell wail constituents (PG or MDP) elevate IL-4 induced IgE synthesis in patients with atopic dermatitis which lead to exacerbation of skin lesion.

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