We present a case of 2-year-old female with status asthmaticus associated with a highly elevated serum creatinine phosphokinase (CK) level. She was treated with intravenous aminophylline, intravenous hydrocortisone and isoproterenol continuous nebulization on admission. Despite these therapies, mechanical ventilation was required. After this successful treatment, serum CK level was elevated up to 7090IU/l three days later.
She had muscle weakness in the trunk and both upper and lower extremities for several days. Myopathy by rhabdomyolysis was considered. Muscle power slowly improved. We must pay attention to serum CK level in the management of status asthmaticus.

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We studied the relation between the birth month and the manifestation of allergic diseases (bronchial asthma, atopic dermatitis). The subjects consisted of 771 children aged under 5 who were diagnosed as allergic diseases (bronchial asthma, atopic dermatitis) in our hospital between May 1995 through April 1998, and they have kept subsequent clinic appointments after April 1998. On the clinical card, we examined the birth month, the visit month, Total IgE, IgE RAST score (dermatophagoides pteronyssinus, albumen), the number of eosinophils in the nasal discharge, and Total IgG. The result is that allergic diseases (bronchial asthma, atopic dermatitis) were not common in the children born in spring, while common in the children born in autumn, and the tendency was marked in atopic dermatitis. The average age in month of first visit of the infants was 5.4 months old, and the total number of visits was large in spring. A significant relationship was not found between the birth month and the values of Total IgE, IgE RAST (dermatophagoides pteronyssinus, albumen), eosinophils in the nasal discharge, and total IgG. The concrete mechanism remain to be accounted for, but there was a rerationship between the expression of allergic diseases (bronchial asthma, atopic dermatitis) and the birth month, and it was suggested that it correlated with the environmental factor which connected with the season of some months after (or before) birth.

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House dust mite is the chief allergen for atopic patients, and for environmental control, it is important to measure the level of this antigen in house dust of each patient's house. We investigated the usefulness of ACLOTEST, a new simple kit for detecting mite antigens in house dust. Using 61 dust samples gathered by electronic cleaner in 29 houses, there was a staistically significant relationship between Aclograde (5-grade classification of the results of ACLOTEST) and ELISA class (5-grade classification of Der I measured by sandwich ELISA), and the correlation coefficient was 0.602. Though larger quantity of dust sample is needed for ACLOTEST than for sandwich ELISA, ACLOTEST is simple, rapid, and requires no specific instrumentatients.
These observations suggest that ACLOTEST is useful as a simple method to detect the level of mite antigen in house dust samples by patients themselves.

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We investigated the clinical features and the questionnaire for family to research the cause of recurrent hospitalization with bronchial asthma. Twenty-one patients out of 288 inpatients readmitted over three times for two years (1996-1997). They were 14 boys and 7 girls, ranged from 3 to 12 years old (average 5 year 9 months). As a result, we noticed that guidance for management to acute attack at home was important. We classified these patients to four group, they repeating admissions only for this two years (group 1:6 patients), they repeating admissions before this two years but no hospitalization after this two years (group 2:7 patients), no hospitalization before this two years but repeating admissions (group 3:4 patients), repeating adomissions before and after this two years (group 4:4 patients). Patients of groups 3 and 4 (recurrent hospitalized at the present) continued same therapy for long times because of difference recognizing severity between the medical team and pateient's family. In conclusion, we considered that exactly recognition of asthmatic severity and appropriate therapy was important to prevent recurrent hospitalization.

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A boy with milk allergy who is 1 year and 1 month old was reported. At 1 year and 1 month old, he presented anaphylaxis, including local erythema that spread into neck and face, and wheezing with dyspnea five minutes after contact with milk allergen through his atopic skin in his anterior chest. These allergic symptoms persisted almost 24 hours. Also he showed pale face, generalized erythema, and irritability immediately after accidental oral ingestion of milk at 1 year and 8 months old. His serum IgE was 590IU/ml, and radioallergosorbent test (RAST) classes against milk, α lactoalbumin, β lactglobulin, casein, and cheese were 5, 2, 3, 5, and 5, respectively. This is a rare case of milk allergy who fell into anaphylaxis both by cutaneous contact with and by oral ingestion of offending milk protein. Care should be taken of patients with food allergy so that cutaneous contact with offending food may cause adverse reactions including anaphylaxis.

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The effects of regular DSCG inhalation therapy and procaterol inhalation were examined in pediatric patients with moderate to severe bronchial asthma by the envelope method. The study was conducted with two groups, Group A (n=10), in which DSCG was administered singly for 4 weeks followed by combined therapy with DSCG+procaterol for 4 weeks, and Group B (n=11), in which the order of treatments was reversed.
Regular inhalation therapy with the combination of DSCG+procaterol was superior to conventional therapy. In addition, treatment with regular inhalation therapy with the combination of DSCG and procaterol followed by single DSCG therapy was more effective than treatment in the reverse order.

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There have been few reports on allergens in tomato fruit, one of foods causing oral allergy syndrome. We examined the major allergens by immunoblotting methods using 25 patients' sera with high IgE antibody titers for tomato fruit. Of these patients, 14 patients showed OAS after eating tomato. Approximately 15 protein bands were reactive to IgE antibodies from the patients. Five bands showed IgE-binding activity with more than 50% of the subjects. These proteins were deduced polygalacturonase 2A (46kDa), β-fructofuranosidase (25kDa and 22kDa), superoxide dismutase (18kDa), pectinesterase (14kDa) by homology search based on N-terminal amino acid sequences. These, except superoxide dismutase, may be proteins related with ripening because they were increased with maturation of tomato fruit.

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