In the treatment of asthmatic children, training has an important role as its effects of improving the physical working capacity, and clinical symptoms of asthma. It was also reported that training effects were seen in the improving of the maximum % fall in FEV1.0 after the exercise and bronchial responsiveness. It is important that these effects on asthmatic children can be obtained without drug. However, appropriate prevention with drug is necessary to make an appropriate training in asthmatic children. So, in order to obtain desired results, to make the good co-operation among doctors, parents, and teachers should be important.

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The aim of this study was to determine whether treatment of neonates with antibiotics before 1-week of age influences the occurrence of allergic disorders. Fifty eight infants in an antibiotics group and 58 infants in a control group were compared. There were no significant differences between these groups in gestational age or in birth weight, but the percentages of premature rupture of membranes and of turbid amniotic fluid were significantly higher in the antibiotics group than in the control group. Apgar score was also significantly lower in the antibiotics group than in the control group. There was no significant difference between these two groups in the usage of formula milk at 1-month of age. Eczema appeared at 4-months of age in 18 cases in the antibiotics group and in 12 in the control group; atopic dermatitis appeared in 4 cases in the antibiotics group and in 3 in the control group. During the course of this study, atopic dermatitis occured in 8 cases in the antibiotics group and in 9 in the control group. There were no significant differences in the appearance of wheezes, bronchial asthma or urticaria between the groups. Bloody stool appeared in 3 cases in the antibiotics group. It was thus not found that the usage of antibiotics in neonates induced allergic disorders.

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In this study, the criteria for diagnosis of middle lobe syndrome (MLS) were the following: (1) atelectasis of the right middle lobe or lingular: (2) at least 3 episodes of middle lobe atelectasis or persistent atelectasis of middle lobe for a minimum 4 weeks. Thirty-two of the 56 children with MLS were boys, 24 were girls. Age at the time of diagnosis ranged from 11 months to 14 years, with a mean (SD) of 5.4 (3.1) years old. Thirty-eight patients (67.9%) had asthma. Patients of MLS with asthma at initial diagnosis were significantly older than patients of MLS without asthma (6.1±3.3 years vs. 4.0±2.0 years). Patients with recurrent episodes had asthma more frequently than patients with persistent atelectasis. (p<0.01)
Twenty-two patients of 38 MLS with asthma were followed for at least 2 years. At initial diagnosis (mean age 6.4±3.8), 5 were classified as severe asthma, 3 as moderately severe asthma and 14 were as mild asthma. At follow-up (mean age 12.5±5.6), 6 were classified as severe asthma, 7 as moderately severe asthma, 8 as mild asthma and 1 was as no asthma. A child without asthma at initial diagnosis as MLS had ongoing asthma symptom after 5years.

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It is difficult to know whether asthmatic child can inhale DSCG solution effectively. The aim of this study was to evaluate inhalation procedure among them by measuring the amount of urinary excretion of DSCG. Next, based on their urinary excretion rate for DSCG, we tried to educate the children who did not inhale the solution efficiently.
The rate of urinary excretion of DSCG was less than 1% in 17 out of 26 patients. Twelve (80%) of 15 patients between the ages of 3 and 7 years and 5 (45%) of 11 patients of 8 years of age and older had a rate of urinary excretion of DSCG less than 1%, which is almost a significant difference (p=0.103). Sixteen (84%) of 19 patients who inhaled distractingly and 1 (14%) of 7 patients who concentrated on inhalation had a rate of urinary excretion of DSCG that was less than 1%, which is significantly different (p=0.005). Nine patients of 17 who showed urinary excretion of DSCG less than 1% were evaluated again after receiving instruction about the inhalation technique. All of these cases showed an increase in the urinary excretion of DSCG.
Measuring the rate of urinary excretion of DSCG made it possible to evaluate whether or not the patients inhaled DSCG effectively, to detect the patients who needed education about inhalation therapy and to determine the effectiveness of the education.

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We established the pediatric standard range of peak expiratory flow in normal Japanese children. We measured the PEF in 2614 students aged 6 to 18 years of age (1241 males and 1373 females) who had no history of smoking, respiratory and/or cardiac diseases, or wheezing, with the Mini-Wright peak flow meter (ATS scale). In agreement with previous studies, we found that the PEF correlated with the age and height of the subjects. Prediction equations for Japanese boys and girls were formulated as follows:
(boys)PEF(L/min)=64.53×Ht(m)³+0.4795×Age²+77.0
(girls)PEF=310.4×Ht(m)+6.463×Age-209.0
The results of the present study are compared with those of previously published works.

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Prevention of asthma death during adolescence is an important target for pediatric allergists. Here we report a case of asthma death, whose severity had been considered as mild-persistent asthma. He admitted our hospital for cardiopulmonary arrest, and died after 11 days of brain death by acute renal failure. Histology of the lung showed mucus plug, goblet cell hyperplasia, thickness of basement membrane and bronchial smooth muscle, all indicated the presence of chronic bronchial inflammation and remodeling. The patient had consulted two physicians independently, both of whom thought his asthmatic symptoms were successfully controlled by their own prescription. In fact, he had been consuming two or more metered dose inhalers every month, and escaped from hard exercise such as running due to the exercise-induced asthma. Presence of exercise-induced attack should be a point to re-evaluate the severity of asthma and start an adequate anti-inflammatory treatment, even in the patients controlled by overuse of metered dose inhaler.

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We measured serum concentrations of Oxatomide, M-11 (active metabolite of Oxatomide), and M-5 (inactive metabolite of Oxatomide) by HPLC in 6 asthmatic patients medicated with 1mg/kg/day twice daily of Oxatomide, and examined the relationship between their concentrations and the clinical efficacy of Oxatomide. Serum concentrations of Oxatomide, M-11, and M-5 after 2-4 hours of medication were 5.5-16.0ng/ml, 4.5-44.3ng/ml, and 0.5-44.2ng/ml, respectively. There were significant negative correlations between the serum concetration of M-11 or the sum of serum concetrations of Oxatomide and M-11, and the clinical asthma score, respectively. However, there were no significant correlations between the serum concentrations of Oxatomide and M-5, and the clinical asthma score, respectively. It might be useful to examine the serum concentrations of active forms of Oxatomide in vivo, M-11 and Oxatomide, simultaneously, when the clinical effect of Oxatomide in asthmatic patients is estimated.

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