Maintenance-Free Smart Hand Dynamometer.

Grip strength measurement is one of the most accessible methods for measuring overall muscle strength, and many studies have shown a link between low grip strength and future diseases. In recent years, devices for grip strength measurements that can connect to digital devices for automatic data recording have been developed. However, such devices have high development costs and require daily maintenance. Therefore, this we propose a grip strength measurement method using the capacitance sensor of a smartphone and no electronic parts on the measurement device side.

[Usefulness of skin prick test using bifurcated needle for the diagnosis of food allergy among infantile atopic dermatitis--second report. In the case of cow's milk allergy].

OBJECTIVE: We investigated the usefulness of skin prick test (SPT) using bifurcated needle (BN) for the diagnosis of cow's milk allergy (CMA) in early infancy. SUBJECTS AND METHODS: Among atopic dermatitis infants with suspicion of food allergy who visited Sagamihara National hospital from January 2001 to April in 2005, 168 cases had received both SPT and IgE ImmunoCAP of CM (CM-IgE) at first visit. We analyzed results of SPT and CM-IgE, focused on infants with negative CM-IgE to examine the usefulness of SPT, and checked positive conversion of CM-IgE with aging. RESULTS: Among 124 infants (73.8%) with negative CM-IgE, 34 infants (27.4%) showed positive SPT results. Forty two infants (33.6%) among the 124 cases were diagnosed as CMA by combination of elimination and provocation test, and 21 infants (50.0%) had positive SPT. In the follow up study of 39 negative CM-IgE cases with CMA, 21 CM-IgE (53.8%) turned positive later infantile period (mean CM-IgE: 4.2+/-4.8 Ua/ml at 9.3+/-5.3 months old). CONCLUSIONS: SPT using BN seemed to be more useful than CM-IgE for the diagnosis of CMA in early infancy with AD. But, the sensitivity is lower than in the egg case.

[Usefulness of skin prick test using bifurcated needle for the diagnosis of food allergy in infantile atopic dermatitis--1st report. Case of egg allergy].

OBJECTIVE: We investigated the usefulness of skin prick test (SPT) for the diagnosis of egg white (EW) allergy in infants with atopic dermatitis who showed negative to EW CAPRAST, and followed up the EW-CAPRAST in this study. SUBJECTS AND METHODS: Data of negative SPT using Bifurcated needle (BN) were analyzed from the data of 202 atopic dermatitis infants, who had received SPT from January in 2001 to April in 2005. From the negative SPT value (average and standard deviation) positive SPT value was obtained. Among 202 cases, 89 suspected-egg allergy infants with negative IgE CAPRAST against EW at the time of first visit were recruited to examine the usefulness of SPT. Positive conversion of EW-CAPRAST was checked in 78 cases (65: egg allergy+, 13: egg allergy(-)) who had been followed up in our outpatient clinic. RESULTS: Range of negative SPT control value (mean+2SD) using BF among infants could be set as less than 2 mm for wheal and/or 5 mm for erythema. Among 89 suspected-egg allergy infants with negative EW-CAPRAST, 72 infants (80.9%) were diagnosed as egg allergy by the combination of elimination and provocation test, interestingly 39 infants (54.2%) showed positive SPT results. In the follow up study of 78 negative EW-CAPRAST cases, 47 EW-CAPRAST out of 65 egg-allergy cases turned positive later infantile period (mean EW-CAPRAST: 9.6+/-16.7 Ua/ml at 9.9+/-5.6 months old). EW-CAPRAST of 7 cases in 13 non-egg allergies also turned positive in the follow up, however EW-CAPRAST titer was relatively lower compared to that of egg allergies (1.1+/-1.5 Ua/ml at 13.3+/-2.6 months old). CONCLUSIONS: We experienced fairly number of atopic infants with negative EW-CAPRAST at the first outpatient visit, who were later diagnosed as egg allergy. In about half of these cases, SPT egg-allergy infants, three quarter of EW-CAPRAST turned positive around 10 months old. EW-CAPRAST of atopic infants without egg allergy also turned transiently and slightly positive. In the conclusions, SPT seemed to be more useful than EW-CAPRAST for the diagnosis of egg allergy in early infantile period, however provocation test should be required for the definitive diagnosis in suspected-egg allergy infants without any proof of egg-sensitization.

[Feature of food allergy developed during infancy (2)--acquisition of tolerance against hen's egg, cow's milk, wheat, and soybean up to 3 years old].

BACKGROUND: Once food elimination is introduced, it is important to know for doctors when patients generally develop oral tolerance against eliminated food. To clarify the point, following study was conducted. METHODS: We analyzed 304 patient profiles with food allergy in our division between 1994 and 2001. The diagnosis of oral tolerance was determined by the results of food challenges or the accidental episodes of ingestion. RESULTS: By the age of 3 years old, 78% of food allergy patients with soybean, 63% of those with wheat, 60% of those with cow's milk, 51% of those with egg yolk, and 31% of those with egg white developed oral tolerance, respectively. IgE CAP RAST scores against cow's milk, egg yolk, and egg white in the patients without tolerance were significantly higher than those in the patients with tolerance. CONCLUSION: Patients developed oral tolerance firstly against soybean followed by wheat, cow's milk, egg yolk and egg white during the first 3 years of life. The specific IgE antibody levels against egg and cow's milk are important for the diagnosis of tolerance.

[Feature of food allergy developed during infancy (1)--relationship between infantile atopic dermatitis and food allergy].

BACKGROUND: Most of food allergy (FA) cases during childhood start as infantile atopic dermatitis (AD) at the ages of a few months old. We tried to clarify the association between infantile AD and FA during infancy. METHODS: We analyzed relationship between AD and FA during infancy among patients with 208 cases, who had visited our outpatient clinic with chief complaint of "eczema" from 1998 to 2000. RESULTS: Among 208 cases, 148 cases (71%) were diagnosed as infantile AD, moreover 109 cases (74%) were diagnosed as FA among infantile AD. The most frequent food antigens among infantile AD were egg (72.3%), cow's milk (39.9%), wheat (12.2%) and soybean (7.4%), respectively, in addition to these food antigens, food allergy was widely recognized against peanuts, sesame, meats, buckwheat, fishes and potato. In terms of food antigen, 44 cases with single food allergy against egg were seen out of 46 single allergy cases, whereas 36 cases with double food allergy against both egg and cow's milk were seen in 63 multiple food allergy cases. Although the value of antigen specific IgE against egg and cow's milk was recognized for the diagnosis of food allergy during infancy, even cases with negative IgE against those foods were proved to be food allergy by food elimination and provocation tests. In contrast to egg and cow's milk, positive IgE against rice, soybean, and wheat did not always correlate with the results of the diagnosis of food allergy. Concerning risk factors of AD, family history of any allergy diseases and passive smoking were recognized in comparison with infantile eczema. Neither the nutrition method nor incomplete elimination of diet during pregnancy and lactation had anything to do with the development of AD. CONCLUSION: When infantile AD cases were not improved by environmental control, skin care and application of steroid ointment, it would be important for doctors to think of the possibility of FA.

[Allergenic activity of non-calcinated egg shell calcium].

BACKGROUND: There is few data to prove the safety of egg shell calcium as allergen. Especially, non-calcinated egg shell calcium is not allowed to use without the description of origin of egg on food labels in Japan. METHOD: We evaluated the possibly contaminated egg allergens in commercial non-calcinated egg shell calcium made from egg by in vitro methodologies (SDS-PAGE, western blotting, inhibition ELISA and sandwich ELISA) and by single-blind oral non-calcinated egg shell calcium challenge on 6 egg hypersensitivity patients. RESULTS: The allergenic activity of non-calcinated egg shell calcium was almost negligible compared to egg white by all in vitro methods. Furthermore, six patients with egg hypersensitivity were unresponsive to oral non-calcinated egg shell calcium challenge test. CONCLUSION: These results indicate that there is little contamination of egg white in non-calcinated egg shell calcium, and that the allergenic activity of non-calcinated egg shell calcium is equivalent to that of calcinated egg shell calcium.

[Thalidomide therapy for infantile-onset Crohn's disease].

A 6-month-old boy was diagnosed as having Crohn's disease (CD) by the endoscopic examination. Primary immunodeficiency syndrome was initially suspected due to a refractory infection that occurred just after birth and a family history that his older brother died at the age of 3 months of septicemia associated with perirectal abscess. Thalidomide was used because conventional medical treatment by steroids and immunosuppressives was ineffective. Thalidomide improved the symptoms of diarrhea, abdominal pain, high fever and fistula, and the PCDAI score decreased markedly from 45 to 15. Although thalidomide was discontinued after three months because of the onset of side effects, including edema, rash and the peripheral neuropathy, the effect on the fistula closure was maintained over a long period of time. Further studies will be necessary to determine the dosage of thalidomide that does not elicit side effects, but thalidomide seems to be effective in patients with refractory CD. Infantile CD is very rare and the diagnosis is often delayed. CD is generally resistant to medical treatment. More detailed information of infantile CD will be needed to elucidate the pathogenesis of this disease and progress of treatment. Recently the incidence of inflammatory bowel diseases has increased. CD should be suspected in any infant with the perianal lesion (fissures, fistula, skin tag and abscesses) especially when prolonged gastrointestinal symptoms, stomatitis or fever coexist.

[The prognosis of asthmatic children with status asthmatics in early childhood].

To clarify the prognosis of asthmatic children with status asthmatics in early childhood, we retrospectively investigated 113 patients (boys: 62, girls: 51) who had been treated as status asthmatics since 1995 through 2000 in National Sagamihara Hospital. In this study, the frequency of admission was decreased year by year, 62.8% (1st year), 29.2% (3rd year), and 5% (5th year). All patients were evaluated as severe or moderate patients during the 1st year from the episode of status asthmatics. Three years after the episode, 38% of patients were evaluated as severe or moderate patients. Five years later, only 20% of patients were evaluated as severe or moderate patients and 35% became free from treatment and asthma attack. Most of the patients were treated by DSCG inhalation and RTC therapy. Nine patients needed BDI therapy in addition to DSCG and RTC. With appropriate and careful treatment, the prognosis of the patients who had experienced status asthmatics in the early childhood was kept relatively well.