22 November, 2008

Whooping cough (=Pertussis )

 see →  http://fr.youtube.com/watch?v=dZ5jf-5MobE&feature=related

❑  What is whooping cough ?
      see   the video clip of  You Tube
      If the infant who received 1or 2 doses of DTaP vaccine, 
      the symptoms such as paroxysmal coughing and 
      inspiratory whoop are not typical.  

❑ Age at risk :  Infant(one-year old or below) 
❑ Etiology:  Gram-negative Bacillus, Bordetella pertussis
❑ Transmission route:  human to human, air droplets
❑ incubation periods:  6~20 days

Any questions:   write to Keiji Hagiwara MD

21 November, 2008

Fever lowering drug

Photo: Fever lowering drugs for children.
from Top ; Acetaminophen powder.
---------- Rectal suppository(200mg)
---------- Rectal suppository(100mg)
---------- Rectal suppository(50mg)

Acetaminophen(=paracetamol) is safety drug for child.
However, the potency for fever-lowering effect is not so strong
and weak pain-relieving effect.

Dosage: 10~15 mg/kg, every 4~6 hours

Any questions: write to Keiji Hagiwara, MD

16 November, 2008

Egg allergy and influenza vaccine

A case of Egg allergy
Flu or Measles vaccines can not be vaccinated in the child
who have egg allergy. To make influenza vaccine, eggs are
used to propagation of influenza viruses and it is quite
difficult to remove the residue of egg proteins.

Don't worry ! Egg allergy is resolved in accordance with age.
Here, I show a case.

November 2000.
one-year-old boy with egg allergy came to my clinic.
He experienced the urticaria after eating egg.
IgE antibody titers to egg white(+2/6), egg yellow(0/6)
➞ Intradermal injection test:
❏ influenza vaccine solution(1/10 diluted with saline)
----- 0.1ml 15x17 mm reddishness & wheal.
❏ saline ---- 0.1ml 5x5 mm.
→ stop the injection of influenza vaccine.
January 2001. (2-year-old).
➞ Intradermal injection test;
❑ Measles vaccine(1/10 dilution) 0.1ml ---- 2x2 mm
❑ Control(saline) 0.1ml ---- 2x2 mm
→Injection of Measles vaccine resulted no problems.

August 2004. (4-year-old).
IgE antibody titers to Egg white(0/6). Mites(+6/6)
House dusts(+6/6).
November 5th, 2004. (5-year-old).
Influenza vaccine was administered, and no side effects.
November 19th. second shop of Flu vaccine. no problems.

Any questions: write to Keiji Hagiwara, MD

13 November, 2008

Walking course in Tokiwa park

Tokiwa Park → http://ww52.tiki.ne.jp/~zaiubetokiwa/

A relatively large pond is situated in Tokiwa park.  
Round trip around the pond is about 6km,  it take
30 minutes by walking.   The wood chips are partly
embedded in the walking course. 

Playground including Roller coaster for children, 
Zoo, Tropical botanical garden also available.

10 November, 2008

Influenza vaccine

Photo 1) Influenza virus.                     
             Linda Stannard, Department of Medical Microbiology, University of 
                 Cape Town.    
Photo 2) Influenza vaccine

Influenza vaccine for this season contain 3 strains.      
i)  A/Brisbane(H1N1)     
ii)  A/Uruguay(H3N2)    
iii) B/Florida

The dosage for child and administer 2 doses( at least, separately 
by 1 week ~ 4 week).

 1     ~    6        ------- 0.2ml
 6≧  ~   13       ------- 0.3ml
  13 year ≧       ------- 0.5ml

At present, Nasal type vaccine(live, attenuated) is not available 
in Japan.  It's  very simple one. Just spray the vaccine solution
into each nostrils. It's trade name is Flumist® and manufactured 
by MedImmuneLLC.  

I hope, quickly being conducted the clinical trial of this vaccine
in Japan.

Any questions:  write to Keiji Hagiwara, MD

08 November, 2008

The publication of Dr. Yamanaka's paper: one year after

Photo: Beating Cardiomyocyte derived from human iPS cells.
           → Cell, vol.131, issure 5, 861-872, 30 November 2007.
In November 2007, Dr. Shinya Yamanaka ( Kyoto University, 

Japan ) published the breakthrough technique on human stem 
cell research in the journal " CELL".

He established the stem cells from adult human fibroblast !
You can see the Movie clip in the section of supplemental
data. Click the “ Movie S1. “.

There are several points to overcome;
i) another method is necessary to insert the genes, since
---retrovirus vector frequently induce tumor.
ii) To find the method for differentiating into normal specific
---cells or organ (neuron, hepatocyte, hematopoietic cell,
---muscle cell ------- ) without tumorigenesis.

I don't know the recent advances on this topic.

Any questions:  write to Keiji Hagiwara, MD                         

03 November, 2008

Norman Heatley. 1911-2004 (2)

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He was a member of "Penicillin project" at Oxford University and co-author
of the Lancet article. Heatley contributed the technical device and idea for the
assay or extraction, isolation of penicillin.

He lived longer, died at age of 93 in 2004. An interview with Heatley is
appeared at the site. In 1990, Norman George Heatley was awarded the unusual 
distinction of an honorary Doctorate of Medicine from Oxford University, the 
first given to a non-medic in Oxford's 800-year history.

Below is excerpt from the his article. He wrote in plain languages. His writing
style represent the personality, I think.

Heatley NG, A method for the assay of penicillin. Biochem J.1944; 38(1): 61–65
A Method for the Assay of Penicillin
(received 18 December 1943)

Practical details of the method

i) Pouring the plates:
------- 4 in. Petri dishes are poured to a depth of 3-5mm with
a simple medium such as ---------
ii) Seeding the plates:
Staphylococcus aureus, no.6571 of the National Collection of
Type Cultures, is used as test organism.-------- The plates are
seeded by placing on each a small volume of a 16-24 hr. broth
culture (or a 10-100-fold dilution of such a culture). --------

iii) Preparation of solutions for assay:
The pH of the solution should be within the range 5.0-8.0.

iv) Placing and filling cylinders:
--------- Carefully placed on the surface of the agar. There may
be a very brief sizzling sound (though the cylinder should scarcely
be hot enough to cause this) and a perfectly fluid-tight seal is
made between agar and the cylinder. The cylinders are not
pressed into agar. The solution to be assayed are then placed
in the cylinders, care being taken that there is no air space
between the fluid and the surface of the agar. The exact volume
of fluid seems to make little difference to the assay value, but
in practice the fluid is filled level with the top of the cylinder.

v) Specifications for cylinders:
The cylinders may be made of glass or vitreous porcelain, gazed
or ungazed. 9.6±0.2 mm, by 5.1±0.2 mm. internal diameter and
7.2±0.1mm. external diameter. one end is bevelled internally
and the shape edge is ground perfectly plane; the other end is
colored for easy identification. ------------------

vi) Incubation:
------ 37 incubator for 16-24 hr. Incubation is usually allowed to
proceed overnight but the zones of inhibition are quite distinct
after less than 10 hr. and, if left longer, increase in size only
very slightly. ------------

vii) Measurement of zones of inhibition:

viii) Arranging standard and unknown solutions on the plates:
In prepare ring the plates a number of factors such as batch of
medium, length of autoclaving, drying time of plates, number
of times the incubator is opened during drying, density of
bacterial suspension used for seeding, etc., are not easy to
control in practice.

It has been found that the of the curve relating the diameter or
the zones of inhibition to Concentration of penicillin, as well as
the absolute assay value for any given sample, may vary from
day to day, probably depending on these variables.

Preliminary investigations showed that a quantitative study of
the effects involved would a lengthy and difficult task; the method
is still therefore largely empirical. It is, however, a simple matter
to determine the shape of the curve afresh each day by setting up
with the--------

ix) The penicillin standard:

x) Reproducibility: limit of accuracy
A quantitative idea of the reproducibility of the method is afforded
by a series of 27 assays of a given preparation against the same
standard. Each single potency value was derived from the mean
of four zone measurements, the values being 75, 75, 66, 77, 88.5,
63, 68, 72, ------------ 79, 63.5, 81, 73. The coefficient of variation
of this series (Series A) is 9.0% .

Two further series with ten assays in each were the following
results: Series B: 56, 56, 62, 61, 51.5, 56.5, 57, 55, 56, 60;
coefficient of variation, 5.6%. Series C: 70.5, 62, 72, 68.5,
67, 72, 65, 71.5, 65, 68.5; coefficient of variation, 5.0% .
The scatter within tests and between successive tests is illustrated
by Table 1, which gives the zone measurements actually recorded
for the standard solutions set up in a consecutive series of assays.

-------- If 9% is taken as the coefficient of variation which may
be expected, then for P=0.01 the limits of accuracy for a single
assay in quadruplicate(i.e. a value derived from measurement
of four zones) will be rise to +- 23.2%. For an assay in Triplicate
the limits will be rise to +- 26.9% and for an assay derived from
two zone measurements only they will be +- 36.7%.

For P=0.05, the limits will be +- 19.5%, +- 22.7% and 27.7%
respectively. In series B and C the degree of reproductively
was considerably greater than this, though the reason is not

xi) Possible modifications and applications of the method:
Substitutes for cylinders:
------ instead of cylinders, circular disks of filter paper which
are merely placed on the surface of a seeded plate and impregnated
with the solution to be tested.
Application to substance other than penicillin:
Great caution must be exercised ------- when applied to other
antibiotics. If the inhibitor is not diffusible, the method is obviously
of no use. The composition of the agar may need spcial attention(e.g.
the presence of peptones wpuld presumably interface with sulphonamides
; penicillin B or notatin gives large zones of inhibition in the presence
of glucose, but not in its absebce). --------

Any questions: write to Keiji Hagiwara, MD

02 November, 2008

Ube festival. 2th November, 2008 (3)

Photo 1) shops along side street. These mobile shops 
                are only opening at festival.

 Photo 2)  goldfish scooping shop.
 Photo 3) 
        scooping device is made from fragile thin paper.  
        It is difficult to scoop a golden fish.  You may need
        the training.
         → http://en.wikipedia.org/wiki/Goldfish_scooping

 Photo 4) " Okonomiyaki " -----  Japanese version of  Pizza.

 Photo 5) "Okonomiyaki" ------ Hiroshima version.
              flat thin "bread"(mixture of wheat flour, 
              water without Baker's yeast) is covered 
             cabbages, noodles, thin sliced pork and 
             topping as you like.

Ube festival. 2th November, 2008 (2)

Photo 1)  various "Yatai"(mobile shops) along side street. 
 Photo 2) shop for toddlers.

 Photo 3) " Imagawayaki"
                  The cloth is made from the mixture of water, 
                  wheat flour and eggs with no yeast.  
                  white bean jam put into it.
Photo 4)  "Imagawayaki"
                   blown bean jam.

Photo 5)  "Takoyaki".  
               Using one or 2 stick, turn to down to up for 
               making Ball.  The cloth are make from the 
               mixture of wheat flour and water. Balls contain 
               a pierce of octopus and cabbage, et ct.        

Ube festival. 2th November,2008(1)

Photo 1)  Main street of Ube. Three traffic lane.

Photo 2) student dancing teem from Yamaguchi University.

Photo 3) a Japanese dancing team.

Photo 4) The lover's teem of Harley-Davidson

Photo 5)  The machine to make " Watagashi ".
                sugar-cotton candy.
                Cotton like fibers are radiated from center pot,
                in which heating and melt the sugar powders.  
                By centrifugal force, Melted sugar liquid are 
                scattered to around, and changing into fine 
                fibers during radiation.

Bone fracture

Photo: Fracture of bone(radius). 1 year & 5-month-old boy.
Bone fracture

When the boy overturned, his left arm hit the ground.
The swelling & reddishness of left arm were noted.
The X-ray showed the fracture in the middle portion
of radius bone.

Any questions, write to Keiji Hagiwara, M.D.
E-mail: keijihagiwara@gmail.com

01 November, 2008

Sweet potato

Photo 1. ) The sweet potatos.
Photo 2)   Sweet potatos. small~medium sized one. 
                   left lower corner is Zippo lighter.

Sweet potato
  → http://en.wikipedia.org/wiki/Sweet_potato

Today afternoon, I harvest the sweet potatos in my home.
In May, I planted 10~12 young potato's seedlings.

The cooking of potato is very simple, just boiled/steamed
/ roasted or fried.  

Sweet potato is rich in dietary fibers, vitamin A, C and B6.