SUNY Downstate Medical Center

Helicopter sight seeing, near United Nation Buildings.

SUNY Downstate Medical Center, Brooklyn, New York

Kings Country Hospital Center, Brooklyn, New York

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Any Questions: write to
Keiji Hagiwara, MD
Kami-Ube Pediatric Clinic,
e-mail: keijihagiwara@gmail.com

Vanderbilt University Medical Center

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Downtown of Nashville, from hotel window. Photo; taken September 1995

Vanderbilt University campus is located a few km West-South from downtown.

The bronze stature of the shipping and rail magnate "Commodore" 

Cornelius Vanderbilt, who provided Vanderbilt its initial $1 million endowment.

Vanderbilt University Medical Center

Dr. Ouchi and me

A party in the campus.

A football match.

Any Questions: write to
Keiji Hagiwara, MD
Kami-Ube Pediatric Clinic,
e-mail: keijihagiwara@gmail.com

Minimum Inhibitory Concentration( MIC test)

MIC test:Tube method

MIC test: Micro titer method

-------- from the homepage of Antimicrobial Test Laboratories

MIC(Minimum inhibitory concentration) is the lowest concentration(μg/ml) of an
antibiotics that inhibit the growth of a bacteria.

A bacteria are culturing in wells or tubes, while an serial dilution of an antibiotics are
adding each tubes or wells for overnight. Cloudy tubes or wells indicate the growth
of bacteria. Clear wells or tubes indicate the inhibition of a Bactria's growth.


Any Questions: write to
Keiji Hagiwara, MD
Kami-Ube Pediatric Clinic,
e-mail: keijihagiwara@gmail.com

Kirby-Bauer antibiotic testing (disk diffusion)

Staphylococcus aureus

Left：Aztreonam disc(30μg/ml).

Right：Vancomycin disc(30μg/ml)

--------Dr. Mizuno, Clinical Laboratory, Yamaguchi University School of Medicine

Kirby-Bauer antibiotic testing (disk diffusion) is a test for determine which antibiotics
is susceptible to a bacteria. A bacteria(Staphylococcus aureus) are grown on agar
plates, while the small discs(containing antibiotics: Aztreonam or Vancomycin) are
placing for overnight. Clear zone indicate the inhibition of a bacteria's growth.

Any Questions: write to
Keiji Hagiwara, MD
Kami-Ube Pediatric Clinic,
e-mail: keijihagiwara@gmail.com

Flu vaccine (2010~11)

This year's flu vaccine contain 3 strains of influenza viruses.

1) influenza virus strains included:
ーーーーーーー A strains: A / California / 7 / 2009 (H1N1)
ーーーーーーー-ーーーー A / Victoria / 210/2009 (H3N2)
ーーーーーーー B strains: B / Brisbane / 60/2008

2) Number of vaccination: 1-year-old-----under 13-year-old: twice (1~4 weeks apart)
ーーーーーー-------ー---ー 13 years or older : once.

3) Cost: 1st: 3,600 yen, 2nd: 2,550 yen


Any questions:
-------------------- write to Keiji Hagiwara, keijihgaiwara@gmail.com

Exanthema subitum( Roseola)

Clinical course of Roseola (Exanthama subitum)

---------------------------------------
Roseola= Exanthema subitum
---------------------------------------
This disease may suffer 2/3 of the Japanese child.

Etiology: human herpes virus - 6.

EM image : x 25,000(Dr. Kazuto Yamaguchi,Department of Animal

Experiment, Yamaguchi University School of Medicine)

Age: 3 months to 3 years (frequently 7 months~ 1.5 years)

Clinical course:

||||||||||||||||||1) high fever(39~40℃) last for 3~5 days.
||||||||||||||||||||||| but child do not seem very sick.
||||||||||||||||||2) no cough, no runny nose( frequently, loose or watery stool) .
||||||||||||||||||3) a fever subside, then a red rash appear in body.
||||||||||||||||||||||||The type of rash is variable; Rubella like~Measles like~
||||||||||||||||||||||||or diffuse pink rash. Rash disappear in several days.


Complication:
|||||||||||||||1) febrile convulsion
|||||||||||||||2) encephalitis (rare)

Questions ? -------  write to keijihagiwara@gmail.com

Pinwheel

Pinwheel: a windmill toy

Windmill in Kinderdijk

blowing a pinwheel

While children is blowing a pinwheel toy （風車 Kaza-guruma in Japanese),
you may easy to hear the sound of the bronchi or lung.

From autumn to winter, the infant and toddler often suffer from wheezing
(Asthmatic) bronchitis. Using windmill toe, you never miss.

Any question: write to Keiji Hagiwara, M.D.
                                   Kami-Ube Pediatric Clinic
                                   keijihagiwara@gmail.com