[A comparison of two delivery devices on the bronchodilatory effects of procaterol from a metered dose inhaler].

The bronchodilatory response to procaterol delivery by a metered dose inhaler with a spacer device (Volumatic) and a corniced extension tube was studied in a double blind manner in 18 asthmatic children, who were brought to our emergency room with acute attacks. The mean percent increase in forced expiratory volume in 1 second (FEV1) with the Volumatic was 55.6 +/- 39.3%, and 46.2 +/- 37.4% with the extension tube. There were no significant differences in the mean percent increase in FEV1, forced vital capacity (FVC), maximal flow rate at 50% of vital capacity (V50), maximal flow rate at 25% of vital capacity (V25) and peak expiratory flow rate (PEFR) between the two devices. It is concluded that there is no difference in the bronchodilatory effects of the two devices. The corniced extension tube has the advantage of being less expensive and more convenient to carry around.

[Clinical epidemiology of bronchial asthma in children report. No. III. Comparison of prevalence of asthma with 1982 and 1990 and environmental factors].

UNLABELLED: In 1982, our group carried out a survey by the questionnaires and on the site medical check-ups to observe and occurrence of asthma and other allergic symptoms in elementary and junior high school children in Izu Ohshima island. Same procedure was repeated in 1990 for 1145 children of the same age group to see any data fluctuation. The occurrence of allergic symptoms with relation to living conditions was also researched. RESULT: 114 students (11.0%) had either suffered from asthma in the past, or were still currently exhibiting symptoms, this marked a 7.5% rise (108 students) over the 1982 research data. However, patients in need of current treatment numbered 48 (4.5%), which was similar to the 1982 data of 82 (4.3%). For other allergic symptoms, rhinitis showed a marked increase over the 1982 data. The relation between living conditions and asthma was analyzed by Multiple Factor Analysis Quantification Theory. RESULT: 1) Family history of allergy, 2) Selection of food products upon starting solids during infancy, 3) Infection of lower bronchus during infancy all seemed to have had much influence on the occurrence of asthma.

[IgE.IgG4 antibody in eczema in infants between 5-7 months of age. I. Relationship to the degree of eczema involvement].

Assessments have been made of serum IgE and IgA value, specific IgE and IgG4 antibody titers to foods, house dust, mite and percent peripheral++ eosinophil count in 191 infants with and without eczema between 5-7 months of age. Eczema patients were divided into 4 groups according to the degree of eczema involvement and laboratory data were compared between these and not eczematous group. The results were as follows; 1) IgE antibody titers were higher as the degree of eczema involvement increased. 2) RAST positive rates to foods increased with the degree of eczema involvement. Positive rate was highest to egg white followed by milk, soybean, wheat and rice. 3) Only 9 cases were RAST-positive to rice or wheat and all of them had IgE antibodies to other allergens tested. 4) A value of 10 IU/ml, which is the lowest measurable value of IgE in infants was considered to be a little too high to speculate allergy to some foods. 5) Specific IgG4 antibodies were positive only to milk. 6) All the 18 cases with positive milk-specific IgG4 antibody were all negative in milk-specific IgE antibody, and conversely all the 14 cases with positive milk-specific IgE antibody were negative in milk-specific IgG4 antibody. From these results, it was concluded that food allergy is related to the degree of eczema involvement in infants between 5-7 months of age.

[Study of IgE.IgG4 antibodies on eczema in infants. II. Clinical characteristics of infants with egg white.RAST 4+].

The author made an assessment in his first report, regarding relationship to the degree of skin involvement. As a result, it was suggested that the extent of eczema is a good index for determining the severity of the allergy and also that the severity of the allergy early in the infancy has a good correlation with egg white.specific IgE antibody. Therefore, an assessment had been made this time regarding the clinical characteristics of 32 infants who have strong reactions (egg white.RAST 4+) to egg white. The results were as follows; 1. All the infants with egg white.RAST 4+ had a systemic eczema, and their IgE antibodies showed high values of 445.6 +/- 626.9 IU/ml. 2. There were many cases with positive multiple allergens. Particularly, all the infants with egg white.RAST 1+ - 2+ were negative to rice and wheat, while 7 cases positive RAST score to rice and 9 cases to wheat were seen out of the 32 who showed the RAST 4+ to egg.white early in the infancy (rice; p less than 0.02 and wheat; p less than 0.01). 3. If the growth curves of the group from which egg and milk were completely eliminated are compared with the curves of the healthy infants, the height and head circumference were entirely in the normal range while the weight and Kaup index had a trend of being a little low, though they were within the normal range. 4. Regarding family history of allergies, past histories of atopic dermatitis on the mother's side were observed at a high rate.

[A comparison of two delivery methods on the bronchodilator effects of beta 2-stimulant].

The airway response to a bronchodilator, salbutamol delivered by a new handy ultrasonic nebulizer and the compressed air nebulizer was studied in a blind manner. Patients by the ultrasonic nebulizer had better percent increase in FVC and FEV1 significantly and in other parameters showed a tendency to being better than those by the compressed air nebulizer. These results suggest that this ultrasonic nebulizer may be more useful than the compressed air nebulizer as inhalation therapy for bronchial asthma. This ultrasonic nebulizer has several advantages over the compressed air nebulizer. This nebulizer is compact size, light weight and has dry batteries as power source, making it more convenient for travel and use at workplace.

Oxatomide modifies methacholine- and exercise-induced bronchoconstriction in asthmatic children.

Oxatomide is a potent inhibitor of both the release and effects of allergic mediators and is similar to calcium antagonists in chemical structure. It prevents histamine release by inhibiting not only the increase in calcium intake, but also intracellular calcium release. We investigated its effect on methacholine-induced and exercise-induced bronchoconstriction in asthmatic children. Methacholine challenges were performed after oral administration of 0.88 mg/kg oxatomide or placebo in nine asthmatic children in a double-blind placebo-controlled study. Respiratory thresholds were improved in seven patients and log PC20 in the oxatomide group (6.65 +/- 1.34 micrograms/mL) was significantly higher than that in the placebo group (5.74 +/- 1.04 micrograms/mL) (P < .05). Exercise challenges were performed after oral administration of 1.5 mg/kg oxatomide or placebo in eight asthmatic children in a double-blind placebo-controlled study. Oxatomide produced acute bronchodilatation with 6.1% improvement on an average in FEV1. The mean maximal % fall obtained by oxatomide was 13.5%, while that by placebo was 22% (P < .05). These results indicate that oxatomide reduces nonspecific bronchial hyperresponsiveness.

Bronchial hyperresponsiveness changes after 5 months of regular procaterol inhalation therapy in asthmatic children.

It is well known that procaterol has more potent antiallergic properties than previous beta-stimulants. Thirteen children with asthma who could be controlled for 2 months with a regular procaterol aerosol given 4 times/day (10 micrograms/dose) were studied. Histamine challenges were performed before and an average of 5 months after the consecutive treatment. No significant differences were seen in peak expiratory flow values. PC20 increased significantly from 132.9 +/- 127.7 micrograms/ml to 762.4 +/- 1205.7 micrograms/ml after 5 months. These results suggest that asthmatic children who can be controlled with regular use of the beta-stimulant procaterol are likely to have a decreased bronchial hyperresponsiveness.

Treatment of status asthmaticus--hormone changes before and after aminophylline i.v. drip therapy.

The treatment of status asthmaticus is one of the most important factors in controlling the patient with asthma attacks. We have studied hormone changes in status asthmaticus and considered what is the best treatment in the asthma attack condition in children. Antidiuretic hormone (ADH), renin activity, and aldosterone activity are elevated in severe asthma attack conditions, and these high levels are correlated with high levels in Wood's clinical score. It is theoretical that patients with dehydration and respiratory failure show such elevation in hormones, and it is well known that under such conditions beta 2-stimulant enhances renin production. From our study, it is concluded that beta 2-stimulant subcutaneous injection must be considered in status asthmaticus. In children, aminophylline i.v. drip therapy may be one of the best treatments in status asthmaticus.