The role of zinc in the production of atopic dermatitis (AD) was studied, and no significant differences were observed in Zn levels among patients of both AD and bronchial asthma (BA), patients with BA alone, and healthy control group.
In our comparative studies, no significant differences in IgE levels were observed between patients with serum Zn≥80μg/dl and those with levels<80mμg/dl.
However, most of severe cases of AD were found among patients with Zn blood level than 80μg/dl. In some cases, dermatological symptom disappeared when Zn was administrated orally. Moreover, in the comparative studies on Zn levels in hair the levels were significantly lower (p<0.01) in the AD group than in the healthy control group.
These results suggest that Zn may play some role in pathogenesis of AD.

View full abstract

It is known that allergic children have a higher incidence of perioperative complications than general children, and perioperative complications are thus more likely to be found in the allergic children. Although the factors that cause perioperative complications are so complex and analysis is difficult, we focused on which department among the Pediatric Department, Surgical Department, and the Anesthetic Department was most closely related to their occurrence, and studied improvement methods. Problems in the Pediatric Department that were pointed out included a lack of cooperation between outpatient and inpatient pediatricians, inconsistent perioperative management policies, and a lack of participating allergosis specialists. In the Surgical Department, further improvements were needed in the evaluation of asthmatic severity and preoperative questionnaires method of allergic history. In the Anesthetic Department, issues for consideration were the administration route of premedication and method to assure the airway.
The following countermeasures were considered:
(1) introducing a perioperative management manual for allergic children in accordance with the situation of the facility and to increase knowledge consistently,
(2) notifying information about surgical risks with bronchial asthma complications to surgeons in charge when surgery is planned and starting preoperative management of bronchial asthma at the earliest stage, and
(3) active cooperation of pediatrician in charge with the Anesthetic Department for preoperative evaluation and anesthetic method.
These three points were considered to be important.

View full abstract

247 asthmatic and 246 non-asthmatic children were evaluated in order to find out the relationship between the onset of their bronchial asthma and allergic diseases of their parents.
The results of relative risk were as follows.
(1) Relative risk was 6.55 when father has allergic diseases. Relative risk was 3.44 when mother has allergic diseases.
(2) Relative risk was 30.44 when father has bronchial asthma. Relative risk was 9.78 when mother has bronchial asthma.
(3) Relative risk was 14.27 when the onset of parents with allergic diseases in their childhood. Relative risk was 5.23 when the onset of parents with allergic diseases in their adulthood.
(4) Relative risk was 11.42 when the onset of father with allergic diseases in his childhood. Relative risk was 5.23 when the onset of mother with allergic diseases in her childhood.
(5) Relative risk was 39.95 when the onset of father with bronchial asthma in his childhood.
These results suggest that parents, especially father's child-onset bronchial asthma were closely related to their children's bronchial asthma.
We concluded that information about the onset of parents' allergic diseases could help us to predict the development of bronchial asthma in their children.

View full abstract

The tuberculin reactivity was studied in allergic children (bronchial asthma, atopic dermatitis, allergic rhinitis, and/or allergic conjunctivitis). The percentage of positive tuberculin test (≥10mm erythema) in allergic children with atopic dermatitis (group AD) was 55% (53/97 cases) which was significantly lower than those in non-allergic children (group NA) (69%, 524/760 cases) or in allergic children without atopic dermatitis (group AL) (66%, 97/146 cases). A similar result was obtained in the selected children who were not treated with steroids and anti-allergic drugs for their possible immunosuppressive effects. When the tuberculin reactivity was studied in children who had received BCG one year before, it was also found that the tuberculin reaction was decreased in atopic dermatitis children. In order to study whether the decrease of the tuberculin reaction on the allergic children is due to the delayed response or not, the tuberculin reactivity was evaluated at both 48hr and 72hr later. The positive tuberculin reaction at 72hr later in AD children who were negative at 48hr was found 16% (5/31 cases) comparative to those in NA children (16%, 18/116 cases) and AL children (7%, 1/14 cases). The statistical analysis revealed the negative significance. These results suggest that the tuberculin reaction is suppressed in atopic dermatitis children. This needs to be considered when evaluating the tuberculin test in children with allergic disorders.

View full abstract

We evaluated three methods for diagnosis of immediate-type drug hypersensitivity: the histamine release test, the skin test, and the skin chamber method. The histamine release test was performed on 20 children (9 boys and 11 girls) aged 11 months to 11 years. The results were as follows. 1. With the histamine release test, positive results were obtained in 55% (11 of 20) of patients. However, stimulation indexes were usually not dose-dependent even when the test was positive. 2. With the skin test, results were positive in 61.5% (8 of 13) of patients. 3. With the skin chamber method, results were positive in 57.1% (4 of 7) of patients. This rate is thought to be the same as with other methods for diagnosis of drug hypersensitivity.
Our results suggest that 80% of cases of immediate-type drug hypersensitivity would be diagnosed if the skin chamber method were also used. Furthermore, we believe that the combination of these methods may be useful for identifying causative drugs.

View full abstract

Case 1 is a 5-year-2-month-old girl. She was admitted to another hospital for an asthma attack 3 months ago. Because of respiratory failure she was then moved to our hospital, and immediately mechanically ventilated. On the 3rd hospital day she developed subcutaneous emphysema, and was administered isoflurane. After 23 hours, this therapy was discontinued and the endotracheal tube was removed on the 4th hospital day. Case 2 is an 11-year-old girl who had been treated with MDI (metered dose inhaler) of fenoterol and regular inhalation of orciprenaline. She was brought to our hospital in severe asthmatic attack. Though she initially responded to conventional therapy, she no longer responded within several hours. She was thus mechanically ventilated together with administration of isoflurane for 85 hours and pulse therapy of corticosteroid. On the 5th hospital day, the endotracheal tube was removed. Both of above cases showed no significant side-effects of isoflurane. Case 1 improved by isoflurane rapidly, but case 2 needed the longer-term isoflurane inhalation and pulse therapy together. In case 2, inhaled β stimulants were the main treatment despite the severity of the asthma. Insufficient treatment with anti-inflammatry agents was thought to have contributed to the expression of the isoflurane effectiveness.

View full abstract

Gelatin in live vaccines has been considered to be a major substance to induce allergic reactions. In the present study, we measured anti-gelatin IgE antibodies in healthy and allergic children to clarify the sensitization with gelatin in childhood. Anti-gelatin IgE antibody was detected in one of 551 healthy children (0.18%) and 5 of 219 allergic children (2.3%).
Among 5 allergic children, three had severe atopic dermatitis and two had moderate bronchial asthma. No allergic reaction was observed in all five children, when they was immunizated with gelatin-contained vaccines and foods containing gelatin.

View full abstract

We measured oxygen saturation with a pulse oxymeter (SpO₂) among five groups in order to re-evaluate the normal value and the value for asthma attacks with ascending degree of severity: non-asthmatics, childhood asthmatics without attack, with mild, moderate and svere attack. Values were as follows: non-asthmatics (n=118) 98.1±0.7%, asthmatics without attack (n=127) 97.9±0.8%, mild attack (n=31) 96.7±0.7%, moderate attack (n=34) 95.7±1.6%, severe attack (n=36) 91.4±4.2%. No statistically significant difference was found between non-asthmatics and asthmatics without attack, however, every comparison between any other two groups was statistically significant.
Conclusion: 1. Normal value of SpO₂ was considered >96.7%. 2. SpO₂ was less than nomal in approximately one half of asthmatics with mild attacks. 3. SpO₂ decreased and more widely distributed with ascending severity of asthma attacks.

View full abstract