We compared examination data collected from asthmatic children at admission and just prior to discharge from hospital. Subjects were divided into two groups. Group I had first experienced perennial symptoms within 2 years prior to the hospitalization. Group II had been experiencing perennial symptoms for more than three years. We examined patient profiles, medication, lung function, bronchilal hypersensitivity, and exericise ability.
Our results showed no differences in patinet profiles, medication, bronchial hypersensitivity, and exercise ability at the time of admission between the two groups. However, lung function was significantly lower in group II than in group I. At the time of discharge, medication in both groups was reduced or discontinued, but there was no improvement in group II examination data. Values for FEV_1.0, PEFR, V₅₀, V₂₅ and acetylcholine threshold remained lower than for group I.
In conclusion, bronchial hypersensitivity of severe asthmatic children experiencing late institutional therapy was not improved even if symptoms became stable. It was not clear whether bronchial hypersensitivity improved as clinical symptoms improved.
We wish to stress the importance of teaching allergen avoidance and physical training. Also we strongly recommend institutional therapy for severe asthmatic patients.

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It is important to investigate the treatment or condition before and on severe asthma attack to consider preventive treatment, because our hospital is in charge of third medical care as emergency life care center. During 3 years from January 1991 to Decenber 1993, eight asthma patients admitted in ICU. Their past history and laboratory data were investigated. Three of 6 patients, excluding 2 patients admitted on first asthma attack, was administered MDI (β stimulater drug). One of the three was died of asthma. The time from attack to admission of patients administered MDI was shorter than that of patients who was not administered. CRP of 3 patients administered MDI was negative. Two patients used MDI on self-control. The pH of first blood gas analysis of the two were very low (7.04 and 7.05). The time from attack to admission of the two were very short (1.5 and 7 hours). So it is possible that MDI had some effect on the acute exacerbation of asthma attack. Patients administered MDI should be controled as to the usage of MDI.

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In the literature to date, there are no reports of systematic research on any fruit or vegetable allergies in Japanease children. Thus, this study was designed to elucidate features of fruit and vegetable allergy in Japanease children living in metropolitan Tokyo. RAST studies were performed in 175 allergic children with RAST positive to some food. Twenty-eight patients had episodes of fruit and vegetable hypersensitivity. The results of the positive RAST tests for 22 allergens were between 10.9% (banana) and 40.0% (kiwifruit), and increasd with age. The results appeared to indicate these sentizations resulting from cross-reaction between fruit and vegetable. In metropolitan Tokyo, mainly kiwi and tomato induced symptoms. The major manifestations were oral symptoms. The disagreement between RAST, SPT and case histories must be given careful consideration with regard to diagnosis of fruit and vegetable allergy.

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In order to demonsrate whether Interleu kin 6 (IL6) is increased in children with bronchial asthma, we have measured serum IL6 activity by bioassay using the IL6-dependent cell line MH60. BF2 and recombinant IL6 (r-IL6). All children, aged 1 to 15 years, divided into four groups, patients with asthma attack (n=10, we measured 11 times), asthmatic patients without attack (n=3), patients with upper respiratory tract infection (URI) (n=29) and control subjects (n=28).
The serum IL6 activity in patients with asthma attack, asthmatic patients without attack, patients with URI and control subjects was 1.152±0.230, 0.822±0.080, 1.139±0.105, 0.627±0.035U/ml, respectively.
The serum IL6 activity in patients with asthma attack was significantly higher (P<0.05) than that of control subjects, but there was no significant difference in serum IL6 activity between asthmatic patiens without attack and control subjects.
We concluded that in patients with asthma attack, the serum IL6 activity is increased.

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Nagoya City has done screening of infants with eczema, wheezing and a family history of allergic diseases at 3 months' medical examinations in municipal health centers as a means of prevention. Twelve hospitals within the city perform blood test of total IgE, specific IgE (egg white, cow's milk and Dermatophagoides) and eosinophil counts, and offer guidance on living. We studied the results of the blood tests and replies to questionnaires in 249 infants (male 134, female 115, mean age month±S. D., 5.8±2.3, from 3 to 12 months), who were referred from health centers to Nagoya Johoku Municipal Hospital between January 1992 and January 1993. Egg white specific IgE in breast-fed infants was significantly higher than in infants fed mixed or cow's milk. This suggested the importance of sensitization (by egg white) through breast milk. It was concluded that mothers of children with a strong allergic predisposition should be given instructions about food and living environment, considering sensitization (by egg white) through breast milk and the emergence of allergic symptoms.

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We studied time course of the blood peptide LT, LTB₄ and the neutrophil count in blood following food challenge in children with food allergy. Of 13 challenges, 11 challenges induced immediate reactions. The mean blood peptide LT and LTB₄ levels rose significantly at 1 hour after challenge when immediate reactions began to appear. At 2 and 3 hours the levels decreased and they rose again at 4 hours when symptoms continued. The mean neutropil counts in blood began to rise significantly at 2 hours after challenge later than the first peak of LT level and showed the peak at 4 hours. Two challenges induced late reactions. Blood peptide LT levels slightly rose at 1 hour and 4 hours after challenge. Blood LTB₄ levels rose at 6 hours after challenge before late reactions began to appear. The neutropil counts in blood did not rise. This study suggests the elevation of LT may be associated with the appearance and duration of the allergic reaction.

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A micro assay system for measuring interleukin 2 (IL2)-responsiveness by allergen-stimulated lymphocytes was developed for detecting causative allergen in children with atopic dermatitis and/or bronchial asthma using a 60 well micro Terasaki plate and propidium iodide (PI) staining. There was a linear correlation between the number of PI-stained cells (2×10³-6×10⁴) and the fluorescence intensity, indicating that this fluorochromasia assay reflects cell number for the quantitative measurement of lymphocyte proliferation even in a extremely small number of cells. The background was less than 10 percent.
The induced response was observed in lymphocytes from patients with urticaria, atopic dermatitis, and bronchial asthma specifically on stimulation with the antigen causing clinical symptoms. The results obtained by the 60 well micro Terasaki plate were much similar to those in previous reports measured using a 96 well micro plate and PI staining. The present micro-method appears possible to decrease cell number used by approximately one tenth, for screening etiological antigens for the diseases and to easily monitor the clinical activity.

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Iikura et al. and Hirota et al. reported that one year treatment with ketotifen could prevent the development of asthma in atopic dermatitis young children. We had a question that this prophylactic effect is unique for ketotifen or common effects of oral anti-allergic drugs, and planned to study ketotifen and tranilast by open study. One hundred and fifty seven atopic dermatitis patients aged from 2 to 42 months who had no history of wheezing were enrolled to this study and 120 patients gave complete data for analysis: K group (71 patients) received ketotifen, T group (19 patients) received tranilast for 1 year and C group (30 patients) received no anti-allergic drugs. Development of asthma in the studying period (1 year) is 28.2% in K group, 15.2% in T group and 60.0% in C group. Our conclusion is that ketotifen and tranilast have equal prophylactic ability on development of asthma in atopic dermatitis young children. This fidings show the probability that other oral anti-allergic drugs have similar asthma preventing effects, too. The question whether prevention of development of asthma in studying period is life long effect or delay of development should be solved by long follow up of patients. We think it is valuable to study the asthma preventing effect of oral anti-allergic drugs other than ketotifen and tranilast.

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