Forty-two severely asthmatic children, aged 7 to 13 (22 boys and 20 girls), who had received institutional therapy were followed up by measuring ventilatory functions during non-attack periods. Follow-ups ranged from 3 to 10 years. The following conclusions were reached.
In regard to long-term changes in FEV_1.0% there were many cases in which a transient decrease was observed around the age of 8 to 11, started to increase around the age of 11 or 12 and intensified steadily up to the age of 15.
Those whose FEV_1.0% had been higher during their hospitalization tended to show improvment of up to more than 80% in their FEV_1.0%, while those whose FEV_1.0%, had been lower showd limited improvement.
While the patients of the group whose airways were moderately severely obstructed during the hospitalization period had the maximum in allergic factors, those whose airways were the most severely obstructed had fewer familiar predispositions to allergic diseases, fewer complications of atopic dermatitis and lower serum IgE levels than the patients of other groups. Based on these findings, the group with the severest obstruction seems to be involved in intrinsic asthma or allergy except for type I.
It is hoped that severely asthmatic children whose airways are severely obstructed have their pharmacotherapies reviewed and are treated from an early stage with comprehensive medical care, including institutional therapy.

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We studied the effects of disodium cromoglycate (DSCG) on bronchial hyperresponsiveness in 38 mild asthmatic children. The subjects were divided into two groups; patients of group D inhaled 20mg of DSCG 3 times daily and group C had no prophylactic drugs. Acetylcholine inhalation challenge test was performed repeatedly before and after 3 months of treatment (10 cases in group D and 14 cases in group C), 6 months (7 in group D, 5 in group C) and 12 months (15 in group D, 10 in group C). Respiratory threshold of acetylcholine (RT-Ach) did not significantly change after 3 months of treatment and slightly increased after 6 months of treatment in both groups. After 12 months of treatment, RT-Ach significantly increased in group D, but did not change in group C. We concluded that long-term use of DSCG decreased the bronchial hyperresponsiveness in asthmatic children. The number of eosinophils in peripheral blood significantly decreased after 1 year of treatment only in group D. From this results, we guess that DSCG might have the effect on eosinophils contributing to the inflammatory process of asthma and protect against the increase of bronchial hyperresponsiveness.

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The prevalence of allergic diseases in 46, 718 school children in 11 western prefecture of Japan was examined. The results is as follows
1. The prevalences of the following allergic diseases were
Atopic dermatitis (AD): 17.27%
Allergic rhinitis (AR): 15.89%
Allergic conjunctivitis (AC): 6.73%
Wheeze (W): 5.22%
Bronchial asthma (BA): 4.60%
Japanese cedar pollinosis (P): 3.63%
More than one allergic disease: 31.27%
The cumulative prevalence of allergic diseases: 45.47%
2. Higher prevalence rates were found in children who live in urban area, and in boys except for AD.
3. Higher prevalence rates of AR, AC and P were found in elder children and of AD and W were found in younger children. No difference was found in BA.
4. There was no significant difference among nutrition during infancy, type of heating or air conditioning system.
5. Higher prevalence rates were found in children who had family history (parents, brother or sister) of allergic diseases.
6. The higher prevalence rates of these allergic diseases in children were considered to come from the common causes. It is now thought that the causes for higher prevalence should be investigated by the surveillance after the determination of definition of allergic diseases.

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Exercise-induced bronchoconstriction (EIB) is a well-known phenomenon although the mechanisms of EIB are not so clear. In order to study the physiological effects of exercise on asthmatic children, the exercise test with 12.7Kpm/Kg(60rpm) was performed by a bicycle ergometer. Eleven asthmatic children (aged from 7 to 17 years) and seven normal healthy children (aged from10 to13 years) were examined in this study.
The exercise test was performed on a bicycle ergometer. During the test, we recorded the heart rate by continuous heart rate memory and measured an oxygen consumption (VO₂) for the last one minute in 6 minutes of the exercise.
In eleven asthmatic subjects, six cases were EIB positive and five cases were EIB negative. The EIB positive group showed more than 15%decrease in FEV1.0 after exercise, while the EIB negative group and control group didn't show- the significant decrease of FEV_1.0. EIB negative group showed lower value of predicted maximum oxygen consumption (VO₂/maxVO₂) than the EIB positive group and control group (p<0.01). EIB positive group required a longer time to reach the maximum heart rate from the startingpoint of exercise than EIB negative group or control group (p<0.05).
These results suggest that the functional disorder of sympathetic nervous system, such as alpha-adrenergic receptor activation and/or beta-adrenergic receptor blockade, may play a role in the pathophysiological mechanisms.

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We reported a case of an asthmatic boy with chinese restaurant syndrome. The symptoms induced by oral challenge of monosodium glutamate were urticaria and asthmatic attack (wheezing and cough) and they appeared within 15min. He was sensitive to many allergens such as, hen's egg, cow's milk, soy bean, some kinds of fish, some kinds of fruits and house dust mite. Skin examination and histaminereleasing test by monosodium glutamate were performed and the results were negative. Serum gastrin concentration significantly elevated after oral challenge of monosodium glutamate. These results suggest that non-allergic mechanism, suchas gastrin mediated histamine release, may be involved in the development of these symptoms.

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We investigated the positivity rates to various allergens in asthmatic children who visited our hospital, using a skin test and a radioallergosorbent test (BAST). The positivity rates determined by a skin test were as follows: house dust (HD) 64%, Alternaria 17%, Candida 5%, Cladosporium 2%, Cocksfoot 36%, Japanese hop 22%, cat epitherium 32%, dog dander 17%, buckwheat 13% and egg white 8%. When compared to the reported results in the other areas, the positivity rates to pollens and cat epitherium were higher and those to HD and fungi except for Alternaria were lower. Similar results were obtained by the determination of allergen-specific IgE antibody using RAST. We further studied whether the positivity rates in ashmatic children with other allergic diseases were different from those in children with bronchial asthma alone; although the rate to Cocksfoot (54%) was higher in the presence of allergic rhinitis, it is interesting that children with bronchial asthma alone showed a positivity rate of 32%. These findings indicate that the sensitization to allergens varies in different geographical areas and may be influenced by climatic and personal environments.

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