We evaluated intestinal permeability in children with food allergy by the measurement of lactulose/L-rhamnose urinary excretion ratio (L/R ratio) after orally loaded lactulose (a disaccharide) and L-rhamnose (a monosaccharide).
The mean L/R ratio in food-allergic patients restricted major offending foods (eggs and cow's milk) partially was significantly higher than in those restricted major offending foods strictly (p<0.01). Furthermore, the mean L/R ratio in patients restricted major offending foods strictly was comparable with that in healthy subjects (controls). Individual changes in intestinal permeability were also evaluated after elimination diets and after oral food challenges. The mean L/R ratio decreased significantly after elimination diets (p<0.05) and increased significantly after the positive food challenges (p<0.05) in patients with food allergy.
In non-atopic children suffering from respiratory infections during the previous 10 days, the mean L/R ratio was significantly higher than that in controls (p<0.05).
In conclusion, the measurement of lactulose/L-rhamnose excretion ratio was useful to evaluate alterations in the mucosal barrier function under elimination diet and food antigens intake.

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To improve teachers's understanding of asthma and EIA in school children, we investigated the incidence and degree of EIA by questionnaire and exercise provocation tests. Out of 884 childeren in the fourth year of an elementary school, 84 (9.6%) were proved to have asthma.
Ten, 40 and 34 children had EIA frequently (group A), occasionlly (group B), and none (group C) respectively. Seventy five children underwent free-running exercise provocation tests, and 8 out of 8 in group A, 15 out of 39 (38%) in group B, and 6 out of 28 (21%) in group C had more than 20% fall in FEV₁, respectively. And 4 (50%) in group A, 7 (18%) in group B, and none in group C had mor than 50% fall in FEV₁. The simple question about EIA like ours is of much help in understanding asthmatic children with EIA.

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To evaluate the differences in protective effect against hypertonic saline inhalation tests between DSCG aerosols (1puff=1mg) and solution (1A=20mg), nine asthmatic children (male 5, female 4, aged 8 to 14 years-old), institutionally hospitalized, had 4 times of 3.5% hypertonic saline inhalation tests. Each inhalation test was performed at 15 minutes after inhalation of normal saline (control), DSCG aerosols (2puff=2mg), DSCG aerosols (4puff=4mg), and DSCG solution (1A=20mg) at the interval of at least more than 2 day and within 7 days. There were no significant differences in %FEV_1.0 immediately before hyperosmolar challenge between groups. The dose of hypertonic saline provoking the 20% decrement in FEV_1.0 (PD₂₀) was used as the index for protective effect. All DSCG treatments significantly attenuated airway responsiveness to inhaled hypertonic saline as compared to control. Regarding comparisons among DSCG treatments, there was a significant difference in PD₂₀ between DSCG 2puff and 4puff, while no significant differences between DSCG aerosols and solution were observed. In both DSCG 2puff and 4 puff treatment group, subjects were divided into two groups individually, being responder and non-responder group, whose PD₂₀ were improved or not by inhaled DSCG aerosols respectively. Values of PD₂₀ after DSCG 2puff were less than those after DSCG solution and almost similar to those of control in 4 of 5 cases with higher airway hyperresponsiveness, whose PD₂₀ (control) were less than 2ml.
Those results suggest that although DSCG aerosols could afford similar protective effect as well as DSCG solution in mild cases, DSCG 2puff may not be effective in cases with severe airway hyperresponsiveness. Further studies will be required to evaluate the effect of DSCG aerosols with different clinical severity.

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For the purposes of a safe and effective use of theophylline, we estimated the pharmacokinetics of theophylline with Bayesian method in children with bronchial asthma at their attack and remission phase. We selected cases who neither took drugs with any influence on the theophylline pharmacokinetics nor had infectious complications.
There were no differences in the clearance, half-life and volume of distribution statistically between attack and remission phase although it was reported that there was a significant reduction in theophylline clearance in the acute phase.

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Forty-four patients with positive IgE antibody (RAST score>2) to egg white and a history of egg white ingestion received oral challenge test with freeze-dried egg white, and 20 of the 44 cases was challenged with boiled egg white, too.
Disagreement between parents' judgment of patients' egg allergy and oral challenge test results with freeze-dried egg white was observed in 21 (47.7%) of 44 subjects.
The reason might be that their parents made a judgment of patients' egg allergy based on the history of ingestion of heated or processed egg white.
Eleven of 14 patients with positive results of challenge tests with freeze-dried egg white showed negative challenge results with boiled egg white.
We could not expect the results of oral challenge test with boiled egg white by IgE antibody titers to freeze-dried egg white.
Then, it is necessary to perform oral challenge test with not only freeze-dried egg white but also boiled egg white for more detailed dietary instruction to egg arellgic patients.

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We reported that 13.7% of allergic children showed low levels of concentration of at least one of IgG subclass in first report. In this report we represented the fluctuation depend on aging of IgG subclass in the patient with bronchial asthma. The subjects were 8 patients who showed low level in IgG2 or IgG3 and 10 patients who showed normal level in IgG2 or IgG3.
The fluctuations of IgG2 in the patients with normal IgG2 and IgG3 in the patients with normal IgG3 were limited in normal ranges in all cases. One of 3 cases who showed low IgG2 represented increasing in IgG2 level by aging. The level of IgG2 in other 2 cases who showed low IgG2 level increased to the normal level temporally and became lower level by aging again.
The concentrations of IgG3 became in to the normal level in 4 out of 6 cases who showed low IgG3. Other 2 cases remained in the low levels by aging. Three cases out of 4 cases who showed normalization represented the low level which belong to be in the normal range. Accordingrange. According to these results we concluded that some of patients with bronchial asthma showed low levels in IgG2 or IgG3 for long time.

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As part of an attempt to clarify adverse effects of cockroachs and mites upon children suffering from bronchial asthma, measurement has beeen taken of IgE antibodies specific to two cockroach subspecies (Perplaneta fulginosa and Blattella germanica) and a mite (Dermatophagoides farinae) as for 20 asthmatic children.
Its results indicated that the rates of positivity were 25% (5/20) for Periplanate fulginosa, 30% (6/20) for Blattella germanica, and 95% (19/20) for Dermatophagoides farinae in the sera from the children as they were analyzed under Pharmacia's CAP system.
In nine of the cases, detection attempts were made for allergen in the children's houses, where major allergen of Periplanata fulginosa (Per f1) were actually detected in four cases but major allergen of Blattella germanica (Bla g2) were not detected.
Of nine cases in which both IgE antibodies specific to cockroaches and allergens were detected, there was only one case where the antibodies and allergens were positive.
A comparison of the volume of allergens among the positive group of IgE antibodies specific to cockroaches, its negative counterpart, and Dermatophagoides farinae (Der 1) revealed no significant differences among the children's room, kichins and living rooms.

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We examined clinical symptoms and the changes of the MEFV curve under the conditions of different time interval between puffs in asthmatic children, who inhaled β-stimulant with MDI. A total of 23 subjects were studied. There was no significant difference between either mode of inhalation.
In the second trial, we also examined the effects of number of inhalations on changes of clinical symptoms and those of the MEFV curve in asthmatic children in the same manner. 18 subjects were studied. There was no significant difference between 10μg of procaterol as a single inhalation and two inhalations of 5μg.
These results suggest that instruction for the optimal inhalation of β-stimulant MDI in children is to be no need to recommend pauses between the puffs, and a single inhalation may be sufficient to deliver the required dose to obtain an effective response.

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