CAP RAST is a new assay system for measuring allergen specific IgE. The results were compared with those of RAST in 57 allergic children. The correlation between CAP RAST and RAST were very good. The discordant results between CAP RAST and RAST were found in 23 samples. The specificity of each result was confirmed by RAST inhibition test. In case of CAP positive/RAST negative, all samples were inhibited by corresponding allergen extracts but not CAP negative/RAST positive samples. These data indicate that CAP RAST is more sensitive and specific than RAST.

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The effect of adding ipratropium bromide to treatment for acute exacerbation of asthma with salbutamol inhalation was studied in 23 preschool children (mean age 3.7 years, range 2-5) and 18 school children (mean age 9.5 years, range 8-14). Each patient was randomised to receive either salbutamol solution alone or mixed solution of salbutamol and ipratropium. Mitsui's symptom score, %FEV₁ and SpO₂ was recorded before, and 15 and 60 minutes after inhalation treatment. Mitsui's score in preschool children and Mitsui's score and %FEV₁ in school children improved significantly at 15 and 60 minutes after inhalation of mixed solution as well as salbutamol alone. In preschool children, SpO₂ improved significantly at 60 minutes after inhalation of mixed solution as compared with inhalation of salbutamol alone. In school children, SpO₂ improved significantly only at 60 minutes after inhalation of mixed solution as well as salbutamol alone. It is proved that adding ipratropium bromide solution to treatment for acute exacerbation of asthma with salbutamol is more effective in preschool children than in school children.

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A survey on the allergic diseases of elementary school children in Naha City has revealed that particularly atopic dermatitis, of which incidence rate is lower than the national level, began to increase after the return of Okinawa Prefecture to Japan and is now also increasing. In order to make clear its cause, a questionnaire survey, etc. were conducted on their parents to investigate into the changes of children's growth conditions in Okinawa Prefecture after the return.
As a result, it was found that Okinawa Prefecture, since the return, had been following the modernization trends of all other prefectures in the post-war Japan in all aspects of the eating habits (mainly the contents of foods taken), housing conditions (building styles and living environment), family make-up (a nuclear family or not), number of brothers/sisters, the degree of severity of the competitions for entering aschool of higher grade, play methods (play time, friends, indoor or outdoor play), etc. It was also recognized that the households affected by the greater changes in their life style in the course of modernization had their children suffer allergic diseases more frequently.
From the above results, the modernization of life style can be pointed out as one of the causes to developthe child's constitutional tendencies to allergic diseases. Modern life is characterized by the strong control of humanbehaviors. It can therefore be considered that this strong behavioral control may cause physical troubles including skin diseases.

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Fourteen children who had severe asthma and were also undergoing institutional therapy were the subjects of a study of the immediate effects on respiratory function by autogenic training using recording tape. When there was no airway obstruction (%FEV_1.0≥80%) there was no significant change, whereas in case of moderate airway obstruction (40%≤%FEV_1.0<80%), there was a significant improvement of 8% on average. Now that optimal improvement of the degree of airway obstruction and diurnal changes have become an integral part of asthma management, it is thought that autogenic training can be helpful for treating some asthmatic children. Further studies of various aspects of autogenic training, for example the long-term effects, will be necessary in order for it to be widely adopted as a clinically useful method.

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We report on patient with asthma who developed severe anaphylactic reaction to intravenous hydrocortisone.
A 18-years old man complained nasal itching, chest tightness, choking sensation immediately after intravenous Solu-cortef injection for an acute asthma attack. Cyanosis and exacervation of asthma symptom were also observed and he was transfered to our hospital.
Suspecting that the symptoms were induced by a preservative, paraben, contained in Solu-Cortef, we administered another hydrocortisone prepatation without paraben, Saxizon, which again resulted in exacervation.
After the patient was recoverd, we investigated etiology of the reaction.
Intradermal skin test was positive to hydrocortisone, methylprednisolone, and dexamethasone. Prausnitz-Kustner (P-K) test was also positive to hydrocortisone and methylprednisolone. Absorbtion of IgE from patient serum by affinity chromatography abolished the reaction in P-K test.
There results suggest that the patient had IgE antibody to hydrocortison, which possibly caused severe anaphylactic reaction.

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We report here a rare case of 13-years old boy with allergic granulomatous angiitis (AGA, Churg-Strauss Syndrome). He had chest pain, arthralgia at the shoulders, numbness of hand fingers, skin rash, loss of body weight, subcutaneous nodosa, and abdominal pain. Laboratory investigations demonstrated peripheral blood eosinophilia, increase of ESR, hypergamma-globulinemia, positive CRP test, and liver dysfunction. Immunologic examinations revealed positive rheumatoid factor. UCG revealed partial hypokinesis of left ventricle, Typical pathological findings were obtained from skin biopsy. He died about 3 months after the onset of vasculitic illness. The cause of death was thought to be cardiac failure induced by widespread myocardial necrosis.
Great caution should be exerted in cardiac involvement of AGA.

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A 6-year-old boy with vitamin B1 deficiency, so called beriberi, who had had pared down and cored rice-based diet free of cow's milk, soy bean, egg, wheat, beaf, pork and chicken for 3 years was reported. This patient was admitted to the hospital because of difficulty in walking, chest disconfort, vomiting and dyspnea. On physical examination, the patient revealed absence of deep tendon reflex in the lower extremities. The electrocardiogram showed ST-segment depression and negative T wave in leads V1 through V5. The blood vitamin B1 level was 6.3μg/dl, the lactate 47mg/dl, pyruvic acid 3.1mg/dl and TPP (thiamin pyrophosphokinase effect) 37%. Marked improvement of electrocardiogram was obtained by 24 hours after intravenous administration of vitami B1 10mg. Because the IgE-RAST and the scratch test detected no causative food allergens, food restriction was step by step cancelled carefully and then no trouble was seen. In this case, no evidence had been obtained to support that food allergy cause atopic dermatitis, and it was thought that food was one of a number of triggers which exacerbate existing atopic dermatitis.
Therefore, in practice of dietary elimination, it is emphasized that determination of offending food is diagnosed carefully and the patient should be controlled under the doctor which regard to nutritianal status.

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