[The effect of particle size and amount of inhalation on the pulumonary function testsn in asthmatic children].

The effect of three nebulizers, Nisshou and LC plus, were compared by the particle size and amount of inhalation. The improvement of FEV1 at 15 minutes after the inhalation was significantly higher in LC plus than Nisshou (MMD: 7.43microm, 10.76microm). The amount of inhlation were compared between Nisshou with/without Y tube and LC plus nebulizer with/without LC valve system. Nisshou nebulizer with Y tube and LC plus nebulizer with LC valve systems were significantly better than that of LC plus nebulizer without LC valve system. Small loss of inhalation gave us better efficacy. The urinary excretion of disodium cromoglycate (DSCG) was highest in LC plus with LC valve system, Nisshou with Y tube and lowest in Nisshou without Y tube. The elecctric nebulizers produced better in MMD of 5microm and a smaller loss of inhalation. These results suggested that MMD less than 5microm and small loss from nebulizer are very important for inhalation therapy.

Successful reduced-intensity stem cell transplant from one-locus HLA-mismatched unrelated cord blood after rejection of unrelated bone marrow in an infant with myelogenous leukemia.

An 8-month-old girl had acute myelogenous leukemia (EAB M2) that relapsed 5 months after diagnosis during intensive consolidation chemotherapy. She underwent bone marrow transplantation (BMT) from an HLA-A, -B, -C and -DR phenotypically matched, but one locus DRB1 genotypically mismatched unrelated donor, but rejection occurred.Subsequently, she received reduced-intensity transplant (fludarabine/cytosine arabinoside/cyclophosphamide) from one locus HLA-A-mismatched, but DRB1 genotypically matched unrelated cord blood stem cells and remission was induced by acute GVHD (grade II) that progressed to chronic GVHD with involvement of the skin, liver, and gastrointestinal tract. In this case, it seems that remission was induced by an adequate graft-versus-leukemia effect and mild chronic graft-versus-disease due to the HLA-A difference more than DRB1 matched between the patient and the cord blood stem cells.