The efficacy of macrolides on chronic paranasal sinusitis has been reported in many studies. We investigated the clinical efficacy of low-dose and long-term macrolide treatment on sinusitis and asthma in children. Between Sep 1997 and Sep 2000,37 subjects with chronic sinusitis, who were taking low-dose and long-term macrolide treatment, were recruited to this study. Among these subjects,65% were complicated with asthma (24 of 37), and 42% of these (10 of 24), were classified as severe(≤200 points of the scoring system of the Japanese guidelines for the diagnosis and management of asthma). After six months on average, we assessed the sinus radiograph and management score. Findings in the sinus radiograph showed improvement in 62% of the patients. In addition,50%of the asthma complicated patients hsowed improvementof the management score. However, there was no correlation between improvement of the sinus radiograph and the asthma management score. When the sinusitis patients complicated with asthma were classified into two groups according to the asthma management score(≤200 or <200 pts),80% of the severe patients(≤200 pts)showed a significant improvement in asthma compared with the mild patients(<200 pts)..
CO2 laser surgery was performed in 9 children with Japanese cedar pollinosis aged 9-15 years. We evaluated the severity of nasal symptoms and examined the nasal provocation test and basophilic cell counts in the surface layer of nasal mucosa. In the following season, the improve rate of sneezing, nasal discharge, nasal obstruction or symptommedication score was 78%,78%,100%,78% respectively. Provovation test and basophilic cell counts improved to negative after the surgery, whereas those in some cases returned to positive at one year after the surgery.
Patients consisting of 164 children aged 4-15 years were treated by a CO2 laser between July1995and October 2000. CO2 laser treatment of the inferior nasal turbinate is a useful procedure, which can be performed as outpatient surgery under local anesthesia. The short operation time and the good results provide excellent compliance by children. Follow-up was possible in 98 cases. Some 72.4% had excellent or good results after therapy. The patient group with multi-antigen allergy, was suppressed less effectively than those with the house dust-mite allergy. Therefore, the CO2 laser surgical technique can be considered as an effective method in the treatment of nasal allergy in children from a viewpoint of evidence-based medicine.
We followed up a girl with deafness and disequilibrium who was diagnosed a case of congenital cytomegalovirus infection at the age of two months. When the girl was seven years old, we performed a battery of neuropsychological assessment on her. She showed mildly retarded development according to the Kyoto Scale of psychological development. Besides, we found obvious inconsistency between her word vocabulary development and oral conversational ability. Obvious inconsistency was also noted between her visual cognitive ability and fine motor movement. We should therefore bear in mind the possibility of learning disabilities or mental retardation in children with congenital cytomegalovirus infection during language training.