Nihon Shoni Arerugi Gakkaishi. The Japanese Journal of Pediatric Allergy and Clinical Immunology
Online ISSN : 1882-2738
Print ISSN : 0914-2649
ISSN-L : 0914-2649
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Volume 21, Issue 2
Displaying 1-11 of 11 articles from this issue
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  • DO INHALED CORTICOSTEROIDS CURE ASTHMA? : 2007 PERSPECTIVE
    Takao Fujisawa
    2007 Volume 21 Issue 2 Pages 169-179
    Published: June 01, 2007
    Released on J-STAGE: December 26, 2007
    DOIhttps://doi.org/10.3388/jspaci.21.169
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    Recent early intervention studies with inhaled corticosteroids (ICS) for high risk infants with wheeze failed to show that ICS can alter natural history of asthma in childhood. Disappointment on the results, however, has provoked various perspectives on the potentials and limitations of ICS, and future strategies to cure asthma. In this review, the current understandings of ICS for asthma will be summarized and prospects will be discussed.
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  • ROLE OF MUCUS HYPER-SECRETION AND IT'S REGULATION IN BRONCHIAL ASTHMA
    Hirokazu Arakawa, Takahisa Mizuno, Harumi Koyama, Hiromi Tadaki, Hiroy ...
    2007 Volume 21 Issue 2 Pages 180-186
    Published: June 01, 2007
    Released on J-STAGE: December 26, 2007
    DOIhttps://doi.org/10.3388/jspaci.21.180
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    Bronchial asthma is a chronic inflammatory airway disease which brings mucus hyper-secretion in the airways. Mucus plug formation induced by goblet cells hyperplasia and mucus hyper-secretion progresses to airway occlusion, and may be a major contributor to disease mortality. Mucins are complex glycoproteins synthesized in epithelial cells. Mucins are classified by their MUC protein backbone, which is encoded by a MUC gene. Recently, more than 20 human mucin genes are identified. It has been previously demonstrated that several factors, such as epidermal growth factor (EGF), cytokines and virus, may contribute to regulation of mucin genes expressed in airway epithelial cells. Currently, there are no drugs that exert a specific action on mucus production. We have found that glucocorticoid and DSCG may regulate airway mucus hyper-secretion. Identifying mechanisms that affect repression of mucin gene expression will be useful in developing new treatment strategy for bronchial asthma.
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  • PROFILES OF FOOD ALLERGY PATIENTS WITH PRESCRIPTION OF EPIPEN IN OUR DIVISION
    Sakura Sato, Hiroshi Tachimoto, Takahiro Komata, Mika Ogata, Takanori ...
    2007 Volume 21 Issue 2 Pages 187-195
    Published: June 01, 2007
    Released on J-STAGE: December 26, 2007
    DOIhttps://doi.org/10.3388/jspaci.21.187
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    We have prescribed Epipen® for 50 food-allergic patients (male: 33, female: 17, 0.3mg: 15, 0.15mg: 35) during the first six months after Epipen came onto Japanese market. The mean age of the subjects was 6.8 years old and 78% of the subjects were complicated with atopic dermatitis, 52% of those with bronchial asthma. Among 50 cases, 48 cases experienced anaphylaxis (symptoms> 2 organs) mostly due to accidental intake of offending foods at the first time or at the second time. The most common type of food allergy at the onset was ''infantile atopic dermatitis associated with food allergy'' in 36 cases, followed by 8 cases of immediate type food allergy and 4 cases of Food-dependent exercise-induced anaphylaxis (FEIAn). Thirty-one cases with repeated anaphylaxis were even recognized, furthermore the cases with unknown causes and the cases against multiple foods were seen. Among 50 Epipen®-prescribed cases, seventeen years old boy, patient with nuts allergy, actually used Epipen® resulting in dramatic relief of the symptoms. In conclusion, the recognition of Epipen® is not sufficient by doctors and co-medicals, however, it would be important to prescribe Epipen® for the patients with food-induced anaphylaxis consulting with their parents.
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  • COMPARISON OF THE EFFICACY OF PRANLUKAST AND DISODIUM CROMOGLYCATE IN THE TREATMENT OF CHILDHOOD ASTHMA
    Naoki Shimojo, Minako Tomiita, Go Matsuyama, Kiyobumi Inoue, Yoshinori ...
    2007 Volume 21 Issue 2 Pages 196-204
    Published: June 01, 2007
    Released on J-STAGE: December 26, 2007
    DOIhttps://doi.org/10.3388/jspaci.21.196
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    The efficacy of pranlukast hydrate (pranlukast) (7mg/kg/day in two divided doses) and that of DSCG (40mg in two divided doses) in the 8 weeks treatment of childhood asthma was compared in 20 children (2-13 years of age, median 4 years) with mild to moderate asthma without any corticosteroid treatment in randomized crossover regimen. There was no difference in clinical effect between pranlukast and DSCG. Pranlukast improved several clinical markers and reduced asthma relief medication. Furthermore, pranlukast was better than DSCG in improvement of QOL score of the patients and in preference by patients and guardians. Thus, pranlukast is effective for childhood asthma.
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  • RESULTS OF A QUESTIONNAIRE SURVEY ON THE JAPANESE PEDIATRIC GUIDELINE FOR TREATMENT AND MANAGEMENT OF ASTHMA 2005 AND THE JAPANESE HANDBOOK OF PEDIATRIC ASTHMA FOR PATIENTS AND FAMILIES 2004
    -FOR A NEW BETTER ''STAKEHOLDER-ORIENTED'' GUIDELINE-
    Norimasa Fukuda, Shigemi Yoshihara, Takayoshi Tsuchiya, Yumi Yamada, M ...
    2007 Volume 21 Issue 2 Pages 205-212
    Published: June 01, 2007
    Released on J-STAGE: December 26, 2007
    DOIhttps://doi.org/10.3388/jspaci.21.205
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    It is considered that a therapeutic guideline is essential for the provision of improved care to asthmatics. In Japan, a novel Japanese Pediatric asthma Guideline (JPGL) and Asthma Handbook (HB) have been published in the last 2 years. However, the current status of utilization of the JPGL and HB in Japan is not yet clear. To evaluate the level utilization of the JPGL and HB, we conducted a questionnaire survey of allergy specialists and general practitioners. Replies were obtained from 70 practitioners (60.9%) from two prefectures. It appeared that allergy specialists were better aware of and better utilized the JPGL. The level of awareness and utilization of the HB was poor in both the groups. Allergy specialists sought a revised guideline with more information on ''allergen management'', ''early intervention'' and ''allergen examination'' in a revised guideline. The editorial policy of excess expertise of the JPGL was criticized by both allergy specialists and general practitioners. The clinicians also suggested that the guideline should use an easier-to-understand format to serve not only allergy specialists, but also non allergic specialists. Further discussions are necessary to prepare a new and better ''stakeholder-oriented'' guideline.
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  • DIFFERENCES IN RECOGNITION OF DEGREE AND SEVERITY OF ASTHMA ATTACK BETWEEN PATIENT WITH ASTHMA AND PHYSICIAN SIDES
    Kazunori Mezawa, Tatuya Yokoyama, Hideo Sugimoto, Hiroshi Nakano, Tada ...
    2007 Volume 21 Issue 2 Pages 213-221
    Published: June 01, 2007
    Released on J-STAGE: December 26, 2007
    DOIhttps://doi.org/10.3388/jspaci.21.213
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    The parents of children with asthma and the physicians who treated them were asked to answer a questionnaire about the degree and severity (type of attack) of asthma attack to examine the difference in how they recognized the attack at pediatric clinics in Chiba, Kanagawa, Saitama prefectures and others. The following results were obtained: (1) both parents and physicians tended to underestimate the degree of the attack as compared with JPGL2002; (2) for the severity as evaluated from symptoms and frequency, the parents tended to overestimate it in mild cases and underestimate it in severe cases; (3) physicians judged that the clinical course in 38.5% of the patients was less severe than that expected by the therapeutic steps they were actually providing; and (4) for the severity as specified in consideration of the current therapeutic steps, physicians tended to underestimate it as compared with JPGL2002. These results indicate that not a few patients received insufficient treatment because physicians underestimated the severity. It is necessary to provide sufficient information with patients and their parents, while promoting the spread of the guidelines among physicians.
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  • EFFICACY OF AN INDIVIDUALIZED SELF-MANAGEMENT PROGRAM SUPPORTED BY A PSYCHOLOGIST FOR ASTHMATIC CHILDREN
    -EFFECT ON SYMPTOMS, LUNG FUNCTION, AND MEDICAL COSTS-
    Kumiko Matsuzaki, Hiroshi Uchiyama, Yasuhei Odajima
    2007 Volume 21 Issue 2 Pages 222-227
    Published: June 01, 2007
    Released on J-STAGE: December 26, 2007
    DOIhttps://doi.org/10.3388/jspaci.21.222
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    Objective: To evaluate the efficacy of self-management program supported by a pediatrician and a psychologist in outpatient setting.
    Method: Self-management support was administered to six-children with asthma about once a month. We examined daily symptoms, lung function (FEV1.0, V50, V25), and cost of prescribed medication, pre and post intervention.
    Result: There were reductions in symptoms and medication costs, and improvement in lung function.
    Conclusion: It was assured that an individualized self-management program is effective in symptom-control and in effect saving the cost of medicine in children.
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