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Biomedical subjects

Masanobu Shinogami

Publications and source records attributed to Masanobu Shinogami.

8 recordsLinked to original sources
PubMed2005

Effect of myringotomy on prognosis in pediatric acute otitis media.

OBJECTIVE: In children with acute otitis media (AOM), we compared clinical outcomes between groups with and without myringotomy to elucidate the effect of this procedure on long-term clinical course and prognosis. METHODS: Fifty-nine children (29 male, 30 female) with tympanic membrane bulging or middle ear fluid (MEF) at initial presentation were assigned to one of two treatment groups. Group A received oral antibiotics and also underwent myringotomy at initial enrollment (36 cases), while group B received oral antibiotics without myringotomy (23 cases). Clinical outcomes were evaluated by otolaryngologic specialists using pneumatic otoscopy and tympanometry at 5, 10, 15, 30 days and 12 weeks and then every 2 weeks after the initial treatment. Otitis media with effusion (OME), early recurrence and recurrent AOM were used as the evaluation criteria for the prognosis. RESULTS: In group A, 6 children (16.7%) showed transition to OME, 11 (30.6%) showed early recurrence of AOM, and 9 (25.0%) developed recurrent AOM. In group B 10, 8, and 3 (43.5%, 34.8%, and 13.0%) showed these respective adverse outcomes. While early recurrence rates and recurrent AOM rates did not differ significantly between groups, progression of OME was significantly less frequent in group A than group B (P = 0.036). CONCLUSIONS: Lower rates of progression to OME in the group undergoing myringotomy suggested that myringotomy might be effective in preventing this outcome.

Acoustic Impedance Tests↗
PubMed2004

Presence of human herpesviruses in young children with acute otitis media.

Some herpesviruses have been detected in middle ear fluid (MEF) of patients with acute otitis media (AOM), but their role in middle ear disease is unknown. We examined 73 middle ear fluid samples from 73 children with acute otitis media for the presence of four major herpesviral DNA, respiratory viral genomes, and bacterial DNA by multiplex polymerase chain reaction (PCR). Herpesviruses were detected in 16 specimens (22%), with 18 viral infections were identified overall. Respiratory viruses were detected in 35 specimens (48%), 39 viral infections overall. Bacterial DNA was detected in 51 specimens (70%), 60 bacterial infections overall. Clinical outcome was compared in patients with and without herpesvirus DNA, respiratory viral genomes, or bacterial DNA. Progression to otitis media with effusion (OME) was more common when herpesviral DNA was present. Presence of herpesvirus DNA may reflect an immunocompromised state that may make it difficult to eliminate bacteria from the middle ear after infection.

Acute Disease↗
PubMed2003

Role of respiratory viruses in children with acute otitis media.

OBJECTIVE: The role of viral infection in acute otitis media (AOM) has not been fully elucidated. We determined the presence of various respiratory viruses in middle ear fluid (MEF) specimens from children with AOM in order to determine whether viral infection or combined effects of viral and bacterial infection enhance or prolong the inflammation in the middle ear, thus worsening clinical outcome. METHODS: Multiplex nested reverse transcription-polymerase chain reactions was carried out to detect influenza A and B viruses, respiratory syncytial virus (RSV) types A and B, parainfluenza virus types 1, 2, and 3; rhinovirus; and adenovirus in 93 MEF specimens from 79 children with AOM. And we examined whether viral infection with or without an identifiable bacterial infection affect clinical outcomes in AOM. We considered persistent MEF (fluid accumulation in the middle ear persisting up to 1 month after treatment), early recurrence of AOM (within 1 month after initial improvement), and recurrent AOM (more than three recurrences during 6 months of follow up) as indicators for evaluating clinical outcomes. RESULTS: One or more respiratory viruses were detected in 39 specimens (42%); a total of 42 viral infections identified (three specimens were infected by two viruses). Of the 42 infections, RSV type A was detected in 29, adenovirus in eight, rhinovirus in three, and influenza virus in two. RSV accounted for 73% of viral detections. In children younger than 2 years, RSV infection combined with Streptococcus pneumoniae or Hemophilus influenzae infection carried a higher risk for persistent middle ear effusion than infection with RSV infection alone or those bacterial infection alone. CONCLUSIONS: Accordingly, vaccination of young children against RSV as well as S. pneumoniae and H. influenzae is important in improving the prognosis in AOM.

Acute Disease↗
PubMed2003

Use of cartilage plate as tympanic membrane in total middle ear reconstructive surgery for infected radicalized ear.

OBJECTIVE: To evaluate the usefulness of cartilage plates as tympanic membranes combined with total middle ear reconstructive surgery for radicalized ears. STUDY DESIGN: Retrospective study between 1994 and 1999. SETTING: Tertiary care referral medical center. PATIENTS: Seven patients had seven ears with severe chronic otorrhea after radical mastoidectomy. All patients had severe to profound sensorineural hearing loss and expected a trouble-free ear rather than improved hearing after surgery. Patients were followed up for 4 years postoperatively. METHODS: After the middle ear space was cleaned, the tympanic membrane was reconstructed using a plate prepared from the tragal cartilage. The major part of the posterior wall was reconstructed using a conchal cartilage plate. Cortical bone segments were inserted to support the cartilage plate. RESULTS: Preoperatively, cultures of ear discharge were positive for various bacteria. Recovery with dry eardrums was noted in six patients, and one patient showed minimal erosion. No postoperative complications were encountered, but the hearing threshold did not improve postoperatively. CONCLUSIONS: Total middle ear reconstructive surgery is suitable for patients with chronic otorrhea complicating radical mastoidectomy. The use of cartilage plates seems to be clinically appropriate, particularly for patients with severe infection who expect a trouble-free ear rather than hearing gain after surgery.

Adult↗
PubMed2003

Multiplex nested reverse transcription-polymerase chain reaction for respiratory viruses in acute otitis media.

Because respiratory viruses play an important role in the causation and pathogenesis of acute otitis media (AOM), determining which virus has infected a child is important with respect to vaccines and antiviral drugs. In some instances, this information might be used to prevent the occurrence of AOM. We used a rapid, economical, and sensitive diagnostic system involving a multiplex nested reverse transcription-polymerase chain reaction (RT-PCR) assay to detect various respiratory viruses in clinical specimens of middle ear fluid (MEF) from children with AOM in our hospital. Multiplex RT-PCR was completed on 40 MEF samples from 28 infants and children less than 6 years old with AOM. Viral RNA was detected in 17 MEF samples (43%). Respiratory syncytial virus type A was present in 12 samples, adenovirus in 3, rhinovirus in 2, and influenza A (H3N2) in 1. The multiplex RT-PCR assay is recommended to clinical laboratories that are considering adoption of a molecular technique for viral diagnosis.

Acute Disease↗
PubMed2003

Factors associated with poor outcome in children with acute otitis media.

OBJECTIVE: To identify factors determining poor outcome in children with acute otitis media (AOM). MATERIAL AND METHODS: We considered the following factors in children with AOM: age; gender; the presence of group nursing; the presence of siblings; the duration of breastfeeding; and the type of bacteria isolated from the middle ear fluid (MEF) or nasopharynx. The 73 pediatric patients studied included 61 examined in outpatient clinics and 12 seen at a children's home. RESULTS: Of the 61 children examined in outpatient clinics, 32 (52%) had persistent MEF (fluid accumulation in the middle ear persisting for up to 1 month after treatment); 14 (23%) had early recurrence of AOM (within 1 month following an initial improvement); and 14 (23%) developed recurrent AOM (> 3 recurrences during 6 months of follow-up). Using univariate and multivariate analyses, age < 2 years was found to be significantly related to the development of recurrent AOM and an absence of group nursing was found to be significantly related to the development of early recurrence. Persistent MEF was significantly related to the development of recurrent AOM. There was no difference between bacterial species isolated from the MEF or nasopharynx in terms of clinical outcome. CONCLUSIONS: These findings indicate that particularly close long-term follow-up is necessary for children aged < 2 years and children with a middle ear effusion that persists for up to 1 month after treatment.

Acute Disease↗
PubMed2002

Total middle ear reconstructive surgery for the radicalized ear.

OBJECTIVE: To evaluate the efficacy of total middle ear reconstructive surgery (TMRS) for patients with open cavity problems. STUDY DESIGN: Retrospective study of patients treated between 1994 and 1997. SETTING: Tertiary care, referral medical center. PATIENTS: Fifty-nine consecutive patients (62 ears) with open cavity problems (draining ears) who underwent TMRS. MAIN OUTCOME MEASURES: Postoperative states of the ears and complications were evaluated in two groups, with and without persistent purulent otorrhea at the time of surgery. RESULTS: In the noninfected group, ears without otorrhea were maintained in 12 (100%) of 12 ears in the short term and 10 (83%) of 12 ears in the long term. In the infected group, the proportions were 40 (80%) of 50 ears and 35 (73%) of 48 ears, for the short and long terms, respectively. Hollowing and/or retraction of the reconstructed canal wall was observed in 1 (8%) of 12 ears of the noninfected group and in 15 (31%) of 48 ears of the infected group after long-term follow-up. Postoperative complications were encountered in 9 ears (14.5%) in the infected group only. CONCLUSIONS: Total middle ear reconstructive surgery is considered useful for the management of persistent discharge from radicalized cavities. It was found important to minimize infection at the time of surgery to achieve satisfactory results.

Adult↗