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1.
Nihon Jibiinkoka Gakkai Kaiho ; 114(12): 924-7, 2011 Dec.
Article in Japanese | MEDLINE | ID: mdl-22352012

ABSTRACT

Numbers of tonsillectomies may be decreasing in Japan due to troublesome bleeding involved in managing in a small viewing field and relatively low national health insurance point for tonsillectomy. We found coblation tonsillectomy to have advantages of less bleeding, shorter operating time, and less postoprerative pain than conventional tonsillectomy. We found that 40% of those on whom a coblator was used reported no postoperative throat pain, and noted a quick learning curve in decreasing postoperative bleeding in coblation tonsillectomy.


Subject(s)
Tonsillectomy/methods , Electrosurgery/methods , Humans , Microsurgery/methods
2.
Eur J Pediatr ; 169(10): 1221-5, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20440509

ABSTRACT

Conventional microbiology (CM) and real-time polymerase chain reaction (PCR) were used to determine rate and serotype of pneumococcal nasopharyngeal colonization in healthy children and children with upper respiratory illnesses (URI). One hundred and thirty-six healthy children and 79 children with URI were evaluated. Pneumococcal colonization was detected more often by real-time PCR than CM in healthy children (50% vs. 24%, p

Subject(s)
Nasopharynx/microbiology , Pneumococcal Infections/microbiology , Respiratory Tract Infections/microbiology , Serotyping/methods , Streptococcus pneumoniae/classification , Adolescent , Chi-Square Distribution , Child , Child, Preschool , Female , Humans , Infant , Male , Reverse Transcriptase Polymerase Chain Reaction
3.
Auris Nasus Larynx ; 37(5): 594-600, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20392581

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the clinical implication of Haemophilus haemolyticus, one of the closest relative of Haemophilus influenzae, on acute pharyngotonsillitis. METHODS: We applied polymerase chain reaction (PCR) for 16S ribosomal DNA (rDNA) and IgA protease gene (iga) to distinguish H. haemolyticus and H. influenzae. RESULTS: Among the 199 Haemophilus spp. isolated from 214 patients with acute pharyngotonsillitis, 52 (24.3%) H. influenzae strains and 23 (10.7%) H. haemolyticus strains were identified by polymerase chain reaction (PCR) for 16S rDNA and IgA protease gene (iga). All H. haemolyticus strains showed hemolysis on horse blood agar and there were no other Haemophilus spp., nonhemolytic H. haemolyticus and H. influenzae variant strains that had absent iga gene. H. hemolyticus showed close genetic relationship with H. influenzae evaluated by pulsed field gel electrophoresis (PFGE). The cases of acute pharyngotonsillitis showing WBC=7000/mm(3) or CRP=8 mg/dl were frequently found among cases with H. influenzae rather than cases with H. haemolyticus. CONCLUSION: H. haemolyticus is a pharyngeal commensal that is isolated frequently from adults with acute pharyngotonsillitis.


Subject(s)
Adenoids/microbiology , Haemophilus Infections/microbiology , Haemophilus influenzae/isolation & purification , Haemophilus/isolation & purification , Nasopharyngitis/microbiology , Acute Disease , Adult , Anti-Bacterial Agents/therapeutic use , Bacteriological Techniques , Haemophilus/genetics , Haemophilus Infections/classification , Haemophilus Infections/drug therapy , Haemophilus influenzae/classification , Haemophilus influenzae/genetics , Humans , Microbial Sensitivity Tests , Nasopharyngitis/drug therapy , Polymerase Chain Reaction , Serine Endopeptidases/genetics
4.
Auris Nasus Larynx ; 37(2): 137-44, 2010 Apr.
Article in English | MEDLINE | ID: mdl-19505782

ABSTRACT

OBJECTIVES: The aim of this study is to examine the internalization of nontypeable Haemophilus influenzae (NTHi) into human epithelial cells. METHODS: Bactericidal assay was applied to examine the effects of antibiotics against cell-adherent NTHi using HEp-2 cells. A trans-well chamber assay was applied to examine the internalization and penetration of NTHi using Detroit562 cells. RESULTS: The adherence of NTHi to HEp-2 cells was noted after 2h of incubation. Azithromycin had a strong bactericidal effect against both cell-associated and non-adherent NTHi, while ceftriaxone did not show bactericidal effects on NTHi adhered to the HEp-2 cells. Three (60.0%) out of five NTHi isolates from the nasopharynx of children with intractable acute otitis media (AOM) internalized into and subsequently penetrated through the epithelial cells at various degrees. Azithromycin had a strong bactericidal effect against the cell-internalized NTHi, while ceftriaxone was bactericidal only against extracellular NTHi. CONCLUSION: The potential of NTHi as the intracellular pathogen may contribute to the persistent existence of this pathogen that result in the prolonged and intractable clinical course of AOM. Azithromycin may be a therapeutically significant antibiotic for patients with prolonged respiratory tract infections due to NTHi.


Subject(s)
Anti-Bacterial Agents/pharmacology , Azithromycin/pharmacology , Bacterial Adhesion/drug effects , Bacterial Physiological Phenomena/drug effects , Ceftriaxone/pharmacology , Epithelial Cells/microbiology , Gentamicins/pharmacology , Haemophilus Infections/microbiology , Haemophilus influenzae/classification , Haemophilus influenzae/isolation & purification , Otitis Media with Effusion/microbiology , Acute Disease , Cell Line , Child , Dose-Response Relationship, Drug , Epithelial Cells/drug effects , Haemophilus Infections/drug therapy , Haemophilus influenzae/drug effects , Humans , In Vitro Techniques , Microbial Sensitivity Tests , Microbial Viability/drug effects , Otitis Media with Effusion/drug therapy
5.
Eur J Pediatr ; 168(11): 1365-72, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19221788

ABSTRACT

Human Bocavirus (HBoV) as a newly discovered parvovirus has been commonly detected in respiratory tract infections. However, its role in acute otitis media (AOM) has not been well studied. We examined HBoV in Japanese children with AOM and evaluated the virus prevalence together with clinical manifestations and bacterial findings. Overall, 222 nasopharyngeal swabs and 176 middle ear fluids (MEF) samples were collected from 222 children with AOM (median age, 19 months) between May 2006 and April 2007. HBoV detection was performed by PCR and bacterial isolation by standard culture methods. HBoV was found in the nasopharyngeal aspirates of 14 children (6.3%) and in the MEF of six children (2.7%). When HBoV detection results were evaluated with clinical characteristics of children, resolution time of AOM was significantly longer (p=0.04), and rate of fever symptom was also higher in HBoV-positive group (p=0.04). Furthermore, we found positive correlation between detection of HBoV and Streptococcus pneumoniae in the MEF (p=0.004). Nevertheless, nasopharyngeal proportion of S. pneumoniae was similar between virus positive and negative groups. Furthermore, S. pneumoniae was detected as a single pathogen in all MEF of HBoV-positive cases but one, while it presents mixed with other pathogenic bacteria in nasopharynx. In conclusion, HBoV may worsen the clinical symptoms and prolong the clinical outcome of AOM in pediatric population. Finally, HBoV may prime the secondary bacterial infection in the middle ear in favor of S. pneumoniae.


Subject(s)
Human bocavirus/isolation & purification , Otitis Media/diagnosis , Otitis Media/virology , Parvoviridae Infections/diagnosis , Acute Disease , Adolescent , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/diagnosis , Child , Child, Preschool , Ear, Middle/microbiology , Ear, Middle/virology , Female , Humans , Infant , Japan/epidemiology , Male , Middle Ear Ventilation , Nasopharynx/microbiology , Nasopharynx/virology , Otitis Media/epidemiology , Otitis Media/microbiology , Otitis Media/therapy , Parvoviridae Infections/epidemiology , Parvoviridae Infections/therapy , Parvoviridae Infections/virology , Polymerase Chain Reaction , Prevalence , Retrospective Studies , Severity of Illness Index , Streptococcus pneumoniae/isolation & purification , Treatment Outcome
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