Despite increasing pediatric allergy-related disease, school staff support appears to be poor. We examined the prevalence and status of allergic diseases, using an Osaka Medical Association questionnaire focusing on allergic rhinitis (AR) and allergic conjunctivitis (AC). Questionnaires returned by 113 school nurses indicated a 7.2% AR and 4.2% AC prevalence. Children with AR and/or AC reporting problems in school totaled 26%. These included nervous caused by allergy symptoms, sleepiness and study difficulties due to side effects of medication, and the worsening of symptoms. School nurses apparently did not address antigen avoidance sufficiently, however a trend particularly apparent in school nurses not experiencing AR. It is thus clear that school staff mush cooperate more extensively with health-care professionals to implement a system of support for allergic children.
RePure-L® (image quality improvement device) for endoscopic sinus surgery upgrades image quality in charge-coupled device (CCD) camera and TV monitor connection. Focus and detail reproducibility in standard definition (SD) image was improved, as were the depth of focus, which approached high definition (HD) quality. RePure-L® enabled microsurgery record video to be converted a clear image. This device was very useful for endoscopic surgery.
Antithrombotic-antiplatelet and anticoagulant-drugs may be a predisposing factor for epistaxis in the elderly. Temporary discontinuation of antithrombotic drugs trigger ischemic events, such as myocardial infarction, cerebral infarction, and transient ischemic attack (TIA), which are often difficult to predict. A 64-year-old man taking aspirin for myocardial infarction was seen shortly after developing epistaxis from the left nasal cavity. The nasal septum deviated into the left, and the epistaxis came from behind it. Coagulation tests were within the normal range.but the man had slight anemia. Gauze with paste was inserted for angiopressure. Aspirin was stopped to avoid rebleeding, and he was hospitalized for bedrest. Numbness and decreased right-hand grip seen 5 days after admission disappeared after 4 hours. Aspirin was restarted these transient symptoms indicated a TIA. No abnormal findings were seen in head head CT or MRI. No further epistaxis or TIA symptoms were seen and the man was discharged the next day. This case makes 3 important points: coagulability must be assessed before treatment, the antithrombotic drug amounts should be monitored, and timing for re-starting antithrombotic drugs must be considered.
Aim: We determined Japanese cedar pollinosis morbidity in Oshimamura, Hirado City, Nagasaki Prefecture, where cedar forest area is roughly 1%. Methods: Using a questionnaire, we surveyed the 608 households of 1438 Oshimamura residents and examined correlations of Japanese ceder pollinosis, food trends, and length of residence from July 7 to September 22, 2009. Results: Questionnaire recovery was 73.5%. Cedar pollinosis morbidity was 2.65% and significantly lower in those residing more than 6 years than in those residing less than 5 years (χ-square test: p=0.0019). Conclusion: We speculated that low cedar pollinosis morbidity was linked to area's low cedar fores ratio.
Between January 2004 and December 2009, we treated 13 cases of paranasal sinus cysts with orbital symptoms in 13 subjects-7 men and 6 women-from 43 to 87 years old (mean: 65.5 years). Paranasal sinus cysts were in the anterior ethmoid sinus in 5, posterior ethmoid sinus or frontal sinus in 3, and the maxillary sinus or sphenoid sinus in one. Symptoms were eyelid swelling in 6, diplopia and exophthalmos in 5 each, orbital pain in 4, and visual disturbance and headache in 3 each. Nine cases involved postoperative cyst and 4 primary cyst. Those with primary cyst reported common colds just before orbital symptoms, followed by orbital pain or headache. These three also had visual disturbance. These cases were found in computed tomography to have a bony defect of the optic canal. Ophthalmological examination showed that the optic disk had not atrophied. All three returned to expected postoperative visual activity levels. Such cases must thus be diagnosed and treated surgically as soon as possible.
Recent studies have differentiated Mikulicz's disease (MD) from Sjögren syndrome as immunoglobulin G4 (IgG4) systemic disease. We found that subjects with MD often report hyposmia, so we examined clinicopathological and serological findings in 38 subjects 14 men and 24 women with MD, analyzing cases of hyposmia. The mean IgG4 concentration (SD) in such cases was 950.5 (797.5) mg/dl. Of the 38, 16 (42%) had hyposmia, despite the absence of nasal cavity and sinus abnormalities such as obstructive and inflammatory disease. Dividing subjects into, hyposmia (+) and hyposmia (-) groups, we evaluated clinicopathological and serological findings, finding abundant IgG4-positive plasmacytes in the nasal mucosa of the hyposmia (+) group, but not in that of the hyposmia (-) group. We concluded that IgG4-positive plasmacyte infiltration may adversely affect in addition to nasal or/and Bowman's gland secretory activity in the olfactory epithelium in addition to the lacrimal and salivary glands.
We evaluated respiratory functions in 39 volunteers with Japanese cedar (JC) pollinosis exposed to 8,000 grains/m3 of JC pollen in the OHIO Chamber, which stably disperses fixed pollen concentrations, in non-pollen season. PEF, FEV1, FEV1%, and FVC were measured before and after pollen exposure using the “HI-101” spirometer (Chest Co. Ltd. Tokyo). No significant differences were seen in these four parameters, suggesting that JC pollen exposure under these conditions does not affect lower respiratory functions and is safe and tolerable.
Despite benign histological features, inverted papilloma (IP) of the sinonasal tract is aggressive, with local bone erosion and paranasal extent and high risk for local recurrence and associated malignancy. An external approach through a lateral rhinotomy is the gold standard of surgery, but surgical advances suggest that endonasal resection is a viable alternative. We retrospectively analyzed 35 cases of histologically confirmed IP treated from January 1987 to December 2007. The 22 men and 13 women had a mean age of 59 years (range: 18-78). Endoscopic procedures were conducted on 22 sides (63%). An external approach was taken on 13 sides (37%). Local recurrence rate was 27% (6/22) with endoscopic procedures and 31% (4/13) with an external approach. IP-associated malignancy (squamous cell carcinoma) was found in two cases (6%). Endoscopic and external approaches thus both achieve radical excision of tumors with similar recurrence rates. Our experience suggests the importance of selecting the approach appropriate for complete tumor resection.
The local treatment of the nose by otolaryngologists is important and the devices should be sterile, but spray nozzles can't always be changed for every patient. We studied the bacterial condition of spray nozzles, culturing them four times after medical treatment. Spray nozzles were sterilized using 70%ethanol wipes before outpatient care. Cultures 1 and 2 were done using 70%ethanol wipes only before outpatient care and cultured after the last medical treatment. Culture 3 was done using 70%ethanol wipes during medical treatment 1.5 hours after starting medical treatment and bacterial inspection was done immediately after the last medical treatment. In culture 4 the nozzles were wiped by 70%ethanol after the last medical treatment and bacterial inspection was done one hour after the wiping. Various bacteria, including MRSA (Methicillin Resistant Staphylococcus aureus) were detected after medical treatment even if nozzles were sterilized using 70%ethanol wipes during medical treatment. Bacteria were not detected after nozzles were sterilized using 70%ethanol wipes after the last medical examination. We concluded that using a nasal spray nozzle for more than one person risked cross-infection, and that spray nozzles should be wiped using 70%ethanol for every patient.