lighting for Christmas

                                                    colour lighting for Christmas


Kami-Ube Pediatric Clinic,
1-20-2 Tokiwadai, Ube 755-0097
Tel: (+81) 836-29-1155
Fax: (+81)836-29-1156
E-mail: keijihagiwara@gmail.com

Influenza vaccine

Influenza vaccine:
Virus strains：A/California/2009(H1N1)pdm09
-------------------A/Victoria/210/2009(H3N2)
-------------------B/Brisbane/60/2008

-----------------------------------------------------------------------------------------
age　　　　　         volume                 　　　  
-----------------------------------------------------------------------------------------
６months〜３ yrs 　0.25 ml                ２times（２〜４weeks apart）
３yrs〜13 yrs             0.5 ml   　　 　 ２times（２〜４weeks apart）    
13 yrs 　　　　     　0.5 ml 　　　   １or 2 times
-----------------------------------------------------------------------------------------

Any questions:   write to Keiji Hagiwara, M.D.
                                        Kami-Ube Pediatric Clinic, Ube 755-0097, Japan.
                                        keijihagiwara@gmail.com

Rice field

Morning glory

Morning glory

Fireworks in Ube

Morning glory

Herpangina(mouth blisters)

Herpangina: small vesicles(pain+) in palate

                                 ----------------

                                 Herpangina

                                ----------------

1) Season: Summer

2) Age      :  infant and toddlers

3) Course of illness: fever and throat pain resolve few days or more longer.

4) Etiology: enteroviruses (coxsackie virus A or B, echoviruses)

Any questions:   write to Keiji Hagiwara, M.D.  

                                        Kami-Ube Pediatric Clinic, Ube 755-0097, Japan.

                                        keijihagiwara@gmail.com

Topical lotion for sweet rash

This drug has traditionally been prescribed in hospitals. But the number of children
with Miliaria have been decreasing, we have less chance for prescription.


Indications: sweat rash( Miliaria, prickly heat), heat rash, skin irritation and itching
Ingredients: Its main components are zinc oxide, phenol and diphenhydrazine(
                        anti-histamine).
　　1) Zinc oxide　　            30g 
　　2) liquid phenol　              5ml
　　3) Diphenhydrazine oil　 5g 
　　4) peppermint oil　         10ml
　　5) Ethanol 　　　           30ml
　　6) Glycerin                     100ml---------to 1,000 mL with sterile water 


Any questions:   write to Keiji Hagiwara, M.D.  
                                           Kami-Ube Pediatric Clinic, Ube 755-0097, Japan.
                                           keijihagiwara@gmail.com

Hydrangea(2)

紫陽花， Hydrangea

Hydrangea

 Hydrangea

Hydrangea is native to southern and eastern Asia (China, Japan, Korea, 

the Himalayas, and Indonesia) ,  North and South America. 

The leaf, bud and root of Hydrangea are toxic for human, cow and goat.
It contain toxic substances such as amygdalin, anthocyanin, cyanogenetic 
glycoside.



Any questions: write to   keijihagiwara@gmail.com
--------------------Keiji Hagiwara, MD
--------------------Kami-Ube Pediatric Clinic, Ube 755-0097, Japan.

Vaccine: immunization sites

Any questions: write to
--------------------Keiji Hagiwara, MD
--------------------Kami-Ube Pediatric Clinic, Ube 755-0097, Japan.

Streptococcal infection: skin rash

6-year-old female came to Clinic with skin itching and fever.

Throat and tonsil were reddish, and rapid test for group A, β hemolytic streptococci was

positive ------ early stage of Scarlet fever. Oral antibiotics rapidly dissolved the symptoms.

6-year-old: tiny red skin rash with itching.

6-year-old: tiny red eruption with itching.

Any Questions:

Keiji Hagiwara, MD

Kami-Ube Pediatric Clinic,

Ube 755-0097, Japan

keijihagiwara@gmail.com

Cherry blossom: Tokiwa park

3.12. Fukushima nuclear plant disaster: Simulation of atmospheric dispersion of the radioactive plume

March 11th Earthquake and tsunami damaged the nuclear power plant at Fukushima,
where 4 of 6 nuclear reactors have been troubles, leaking the radioactive substances
to the air.

Institute de Radioprotection et de Sûreté Nucléaire(＝IRSN) has published information
on its french website regarding the status of the nuclear reactors at the Fukushima Daiichi
nuclear plant, and the consequences of the crisis.
         http://www.irsn.fr/EN/news/Pages/201103_seism-in-japan.aspx
          http://www.irsn.fr/EN/news/Documents/irsn-simulation-dispersion-en.pdf
It includes :
1) Dispersion of radioactive releases in the air
        http://www.irsn.fr/FR/popup/Pages/animation_dispersion_rejets_19mars.aspx
2) Whole body doses likely to be received by a one-year old infant with no protection
     during the releases
       http://www.irsn.fr/FR/popup/Pages/animation_doses_corps_entiers_19mars.aspx
3) Doses to the thyroid likely to be received by a one-year old infant with no protection
     during the releases
      http://www.irsn.fr/FR/popup/Pages/animation_doses_corps_thyroide_19mars.aspx


Thank you, French IRSN

Keiji Hagiwara, MD
Kami-Ube Pediatric Clinic,
Ube 755-0097, Japan
keijihagiwara@gmail.com

3.11. Tohoku・Kantou Earthquake (M 9.0) and Tsunami

11th March, earthquake(M 9.0) and Tsunami attacked north-west Japan.
Tsumani swept the costal area of Tohoku and Kanto, where many fishing ports and 
town are there, were destroyed.


see the footage: NHK; http://www3.nhk.or.jp/news/jishin0311/
                              BBC;  http://www.bbc.co.uk/news/world-asia-pacific-12722187

Death Toll = 10,804 (confirmed. 28 March)
Missing     = 18,000

In addition, Earthquake and tsunami damaged the nuclear power plant at Fukushima,
where 4 of 6 nuclear reactors have been troubles, leaking the radioactive substances
to the air. The evacuation zone, set by the government, was 20km.

Quake also damaged other electric power plants and resulted the power shortage of 

Greater Tokyo area. ( 60c/s 100v is the west half of Japan and the east half Japan is 
50c/s 100v. Fuji river is dividing border). There are few capacity of 60c/s to 50c/s 
conversion of currency.

Rapid diagnostic test for influenza

Rapid tests for influenza virus infection: 

upper: influenza A

lower: influenza B

In Japan, rapid tests for influenza virus infection are routinely used by Physicians.
10 more products are marketing.

The sensitivities, when compared with viral culture, or reverse transcription 

polymerase chain reaction (RT-PCR)are approximately 85~98 %. 

The specificities are approximately 90~99%.

Both A and B are week positive: false results.

There are several sites to obtain the samples:
---------- 1) Nasopharyngeal swab: the best
---------- 2) Throat swab
---------- 3) Nasal swab

------------ New England Journal of Medicine -------

upper: classical cotton swab

middle: thin cotton swab 

lower: Tip flocked with Nylon fiber

Any questions: write to

--------------------Keiji Hagiwara, MD 

--------------------Kami-Ube Pediatric Clinic, Ube 755-0097, Japan.

Relenza: a inhalation drug for Flu

Zanamivir ( Relenza, GlaxoSmithKline) is a oral inhalation drugs, used in the treatment 
and prophylaxis of influenza caused by influenza A virus and influenza B virus. 

The recommended dose of RELENZA in adults and pediatric patients
aged 7 years and older is 10 mg twice daily (approximately 12 hours apart) for 5 days.
• Two doses should be taken on the first day of treatment
    whenever possible provided there is at least 2 hours between doses.
• On subsequent days, doses should be about 12 hours apart
    (e.g., morning and evening) at approximately the same time each day.

12-year-old boy, influenza A infection

10-year-old girl, influenza B infection

Any questions;   Keiji Hagiwara, 

                           Kami-Ube Pediatric Clinic, Ube 755-0097, Japan.

                           keijihagiwara@gmail.com

Bird Flu (Avian influenza) in Tokiwa park

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February 9th. a black swan was found in dead at Tokiwa lake. The tests showed influenza 

A, H5 subtype, suggesting Highly Pathogenic Avian Influenza A (H5N1) Virus.

           ➙ Avian influenza : resources for health professionals (CDC)

  　

From 9th to 11th, except for Pelicans, 322 swans and 14 ducks have been slaughtered 

for preventing further spreads of Flu.  The swans came from Rotterdam in 1957---------

----- A sad ending.

Swans in Tokiwa park, Ube city

Swans

white swan

Black swans

Questions?

-------------------- Keiji Hagiwara,   keijihagiwara@gmail.com 

Japanese encephalitis

~~~~~~~~~~~~~~~~~
Japanese encephalitis
~~~~~~~~~~~~~~~~~
i) agent: Japanese encephalitis virus( RNA virus).
ii) transmission: the bite of an infected mosquito, primarily Culex species. 

mosquito; carrier of Japanese encephalitis virus(Culex tritaeniorhynchus)
---------- Department of Medical Entomology, NIID, Japan

iii) Disease: a few than 1% of human develop the encephalitis. Most peoples

------ are symptom-free.  Case–fatality ratio is around 20%–30%. 

------ Among survivors, 30%–50% may have significant neurological sequelae.

iv) Incidence of Japanese encephalitis:

----- In Japan, fewer than 10 patients/ year.

----- This virus is the most common cause of encephalitis in Asia, 

----- occurring throughout most of Asia and parts of the western Pacific. 

----- The virus has not been locally transmitted in Africa, Europe, or USA.

------ Centers for Disease Control and Prevention -------

v) prevention:  If you work or travel rural area during summer or rainy seasons,
----------- where mosquito bites are there ,
-----------Japanese encephalitis vaccine( 3 times; 0, 1~4 weeks, 1 year) should
----------- be administered.

Inactivated Vero Cell Culture-Derived JE Vaccine

Any questions;  
       Keiji Hagiwara, MD   keijihagiwara@gmail.com