2009 N1H1 influenza vaccination for children under way

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2009 N1H1 influenza vaccine

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I have been administering the Swine flu vaccine for child with following groups;

The order of priority;

------ i) The child with underlying disease (Bronchial asthma et ct.)

------ ii) 1~ 5 year old with "normal child".

------ iii) elementary school pupils, grade I ~ III ,

------ iv) mother or care taker who have infants less than 1 year old( Dec. 4th ~~ )

------ v) elementary school pupils, grade IV~ VI, ( Dec. 4th ~~ )

The distribution of Swine flu vaccine to Hospitals and Clinics is too slow in Japan.

※ The charge of vaccine(National-wide rates): first shot (3,600 yen)

-----------------------------------------------------------second shot (2,550 yen)

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Age ----------------------------The dosage of vaccine

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1~ 5 -year- old---------------0.2ml x 2 times (apart 1~4 weeks)

6~12 -year-old---------------0.3ml x 2 times (apart 1~4 weeks)

13 year old > ----------------0.5ml x 2 times (apart 1~4 weeks)

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If you wish to be vaccination for your child with above mentioned category,

please call to reservation (Tel : 0836-29-1155).


Thank you,

Keiji Hagiwara, MD

Kami-Ube Pediatric Clinic,

1-20-2 Tokiwadai, Ube 755-0097

Tel: 0836-29-1155

Fax:0836-29-1156
Any questions: write to E-mail: keijihagiwara@gmail.com

Automatic blood cell counter

I purchase the new automatic blood cell counter. because the breakdown
of the former machine, which worked for 12 years.

--------------------------------LC-660(not sold in USA), HORIBA, Ltd.
　　　　　　　　　              　→ http://www.horiba.com/us/en/
Using 10 micro-litter whole blood, you can measure WBC, RBC,
Hgb,HcT, Platelet and the percentages of lymphocyte, monocyte,
and granulocyte. it take only one minute.

Any questions: write to keijihagiwara@gmail.com

Roseola(= Exanthema subitum)

~~~~~~~~~~~~~~~~~~~~~~
Roseola(= Exanthema subitum)
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【Case 1. One-year-old baby】
||||||||||||||||||||||||||||The body temperature in this case is not so high.

||||||||||||||||Usually, the rash of Roseola is unclear one. This case is relatively
||||||||||||||||clear cut one, look like the initial stage of " Measles" rash.
||||||||||||||||The low resolution of Blog's Photography is not suitable to show
||||||||||||||||skin eruption.

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【Case 2.  9-month-old boy】
||||||||||||||||||||||A fever chart: good record !
||||||||||||||||||||||His mother described that skin eruption appear from
||||||||||||||||||||||abdomen→ back|→ face→ hand & foot.

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Roseola(= Exanthema subitum)
~~~~~~~~~~~~~~~~~~~~~~
◎Ages: 6-month-old ~ 1.5-year-old
◎Etiology: human herpes virus 6, and 7(rare) and less frequently Enteroviruses.

Electron-microscopy of HHV-6(x 25,000), Dr. Kazuto Yamaguchi,

Department of Animal Experiment, Yamaguchi University School of Medicine.

◎Ethinic: Roseola is very common in Japanese infant, 2/3 infants suffer
|||||||||||||from this condition. Asian infants (Chinese, Korean ) may suffer
|||||||||||||similar frequency.
◎Clinical course:
|||||||||||||||||1) High fever(39~40℃) last for 3~5 days. but infant 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.
➞    The skin eruption of Roseola is unclear one and many different types.
|||||||||||Sometimes mother will not notice ----- so carefully observe the baby
|||||||||||skin. This is one reason why Roseola's frequency is different among ethnic
|||||||||||groups or nations.
◎Complication:
|||||||||||||||1) febrile convulsion
|||||||||||||||2) encephalitis (rare)

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

Starting the Swine N1H1 vaccine for child

Photo ---------- Two type of Swine flu vaccine(10ml vial and 1.0ml vial)

, made by KAKETSUKEN, The chemo-Sero-Therapeutic Research Institute,

Today(November 21th, 2009), I start to shot the Swine flu vaccine for 41 child

with two groups;

------ i) The child with underlying disease(Bronchial asthma et ct.)

------ ii)1~ 5 year old with "normal child".

The distribution of Swine flu vaccine to Hospitals and Clinics is too slow in

Japan. On 16th November, I had received 10 vials(one bottle contain 10ml)

of the Swine flu(A,N1H1) vaccine from local health authority of Yamaguchi

prefecture.

※The charge of vaccine(National-wide rates): first (3,600 yen), second (2,550 yen)

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

Age ----------------------------The dosage of vaccine

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

1~ 5 -year- old---------------0.2ml x 2 times (apart 1~4 weeks)

6~12 -year-old---------------0.3ml x 2 times (apart 1~4 weeks)

13 year old > ----------------0.5ml x 2 times (apart 1~4 weeks)

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

If you wish to be vaccination for your child(1~5 year old only),

please call to reservation (Tel : 0836-29-1155).

Thank you,

Keiji Hagiwara, MD

Kami-Ube Pediatric Clinic,

1-20-2 Tokiwadai, Ube 755-0097

Tel: 0836-29-1155

Fax:0836-29-1156

E-mai: 1) keijihagiwara@gmail.com

2) keiji-hagiwara@umin.ac.jp

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Sweet potato

Today, I harvest the sweet potatoes (a variety name：鳴門金時）
in my small garden. You may need to dig deeper around 1 m.
I miss to cut some of them with hoe.

Tamiflu and a chinese herb（八角）

Chinese star anise fruits (Chinese: 八角, pinyin: bājiǎo ) is the traditional herb

of the Chinese cooking.

It is the starting material of anti-influenza virus drug Oseltamivir (trade name=

Tamiflu). see ⇒ http://en.wikipedia.org/wiki/Tamiflu

The shikimic acid is extracted from the seeds of star anise in a ten-stage process.

Then, Tamiflu is chemically synthesized(at least 14 steps are necessary) from it.

Thirteen grams of star anise make 1.3 grams of shikimic acid, which can be

made into 10 capsules(oseltamivir 75 mg/ capsule, for treatment of one Pearson).

Star anise is grown in four provinces in China and harvested between March

and May. It is also produced in Lang Son province, Vietnam.

Any questions: write to keijihagiwara@gmail.com

Swine flu( 12-year-old)

Two records of 12-year-old boy with Swine flu, who were treated with Relenza.

In these cases, excellent effect of Relenza.

Relenza is a type of oral inhalation drug for influenza A, B, or swine H1N1influenza

virus infections.　see → http://www.gsk.com/products/prescription-medicines/relenza.htm

Any questions: write to keijihagiwara@gmail.com

Swine flu( 6-year-old)

October 25th. At evening, started fever.

|||||||| ------ Rapid test: influenza-A(+).

|||||||| ------ prescribed Tamiflu dry syrup & acetaminophen granules.

||||||| ---------------- A record of body temperature: 6-year-old. Arrow indicate Tamiflu

||||||| dry syrup intake.

Any questions: keijihagiwara@gmail.com

Swine flu (2-year-old)

Last week, The Swine flu have been spreading among the elementary school

children in Ube（宇部）. It's late start, since Ube city is situated far from the

big city, such as Fukuoka（福岡） or Hiroshima（広島）.

View Larger Map

October 27th. 2-year-old. mother noticed fever at mid-night.

||||| ------- 28th. came to my clinic.

||||| -------------- Rapid test : influenza-A(+)

||||| -------------- prescribed Tamiflu dry syrup, cough syrup & acetaminophen.

|||||||| --------------- Tamiflu dry syrup( a powder for oral suspension )

||||||||| ---------------- arrow indicate Tamiflu intake.

Any questions: write to keijihagiwara@gmail.com

Swine N1H1 influenza Vaccine

---------------- Vaccine for Swine H1N1 influenza virus

October 20th, Swine flu vaccine for health professionals (doctor & nurses)

delivered to my clinic. One vial's cost is 2,937 yen(29.37 $, 1$=100yen).

Of course pay myself.

You can see the influenza trend in Japan

→ http://www.google.org/flutrends/intl/en_us/jp/

Any questions: write to keijihagiwara@gmail.com

RS virus infection(1 year & 6 month old; pneumonia)

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Case presentation: 1 year and 6-month-old boy.

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He had been taken thyroid hormone for congenital hypothyroidism.

Dec.6th. start fever and cough.

|||||||||||| 8th. came to my Clinic. prescribed Erythromicin and cough-syrup.

||||||||||||10th. high fever and developed severe coughing with stridor.

|||||||||||| ------- Moist & dry rales audible in both lower lungs.

|||||||||||| ------- WBC 5,700/micro-L, CRP(++)

------- Rapid test for RS-virus(+).

Chest X-ray showed bilateral infiltrations(+).

||||||||||| ------------- referred to University Hospital.

RS(Respiratory syncytial) virus is one of the major agents, which cause

, common cold, bronchiolitis or pneumonia from late autumn~ winter~spring in infant.

        ➔ http://keiji-hagiwara.blogspot.com/2009/03/rs-virus-infection-in-infant-1.html

        ➔ Lean about RS virus infection : http://www.cdc.gov/rsv/

For preventing the disease, monoclonal antibody to RS virus(Synagis)

should be given every months during autumn to spring, to high-risk babies

such as the low-birth-weight infants or with congenital heart disease or

respiratory problems.

The costs of Synagis is high. At present, public Health insurance cover the

cost in infants at risk, but not "normal infants" in Japan.

Any questions: write to keijihagiwara@gmail.com

Mycoplasam infection (Walking pneumonia)

　　　　Pneumonia due to Mycoplasma pneumoniae.11-year-old female, days 5.

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Case presentation: 11-year-old female

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

Feb. 15th.2008. came to my clinic. She started fever in 11th and went to

a clinic. but fever continued & worsen coughing.

|||||||| Dry rales were audible in left lung.

|||||||| Rapid test for influenza A&B:(-), Rapid test for adenovirues:(-)

|||||||| WBC 5,300. (0.9% Baso, 77.7 % Neut, 19.5% Lym, 1.9% mon. )

|||||||| CRP 1.43mg/dl. ESR 36mm/hr. GOT 43iu/L, GPT 16iu/L. LDH 533iu/L,

|||||||| gamma-GT 10iu/L.

|||||||| Mycoplasma antibody(particle agglutination) : x 1,280.

|||||||| Chest X-ray: homogeneous shadow in left middle area.

-------- refereed to University Hospital. She was treated by minocycline.

-------- Hospitalized from Feb.15th to 22th.

※ As it is called as " walking pneumonia", the severity of this disease is not so serious.

Don't think seriously. The majority of patients are treated in Outpatient clinic, not

regularly refer to Hospital.

i) Causative microbe: Mycoplasma pneumoniae.

ii) Transmission: person to person. close contact with infected person.

---- no animal reservers.

ii) Frequently: autumn~ winter~ spring.

----- circular pattern(epidemic occured in Olympic year) was disappeared in Japan.

iii) most affected ages: 5~7~10-year-old.

Any questions: write to keijihagiwara@gmail.com

Child Heath Check at City Health Center

Well child care have been doing in Ube City Health Center at 3-year-old.

Pediatrician, nutritionist, speech counselor and nurses are joined for this.

Health checks at other ages(1-month, 4-month, 7-month, 1-year, 1 & half
-year-old) are done at individual pediatric clinic. Of course, fees are 
covered by city.

Questions: write to keijihagiwara@gmail.com

Shaghai-Ube Flight

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The flight time, from Shanghai to Ube, is 90 minutes.

The time lag between Ube and Shanghai is 1 hour.

A airplane of China Eastern airlines （中国東方航空）in Yamaguchi-Ube airport.
The Ube bridge(center left of photo), Ube industries,Ltd constructed for the transporting

of cement raw materials.

Sanyou-Onoda city

Entrance of Shanghai Pudong International airport（浦東国際空港）

Duty free shops

Shanghai-Ube chartered flight, not regular one.

Shanghai Pudong International airport(浦東国際空港)

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喜喜 (Double happiness)

A cigarette package, made in China.

Chinese character 喜喜 -------   mean happiness/happiness
I wishes , Happy future in the people of mainland china.


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

Silk clothes, Suzhou

The China dress and Silk clothes

虎丘塔，蘇州（Leaning Tower of Pisa in china）

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Leaning Tower of Pisa in china.

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The Huqiu Tower, or Yunyan Pagoda and Tiger Hill Pagoda,

(Chinese: 云岩寺塔;pinyin: Yún yán sì tǎ or Chinese: 虎丘塔;

pinyin: Hŭ qiū tǎ) is a Chinese pagoda situated at Changmen in

Suzhou City, Jiangsu Province.

The tower was built in the later period of the Five Dynasties

(907-960 AD). The tower rises to a height of 47 m (154 ft).

It is a seven-story octagonal building built with blue bricks.

In more than a thousand years the tower has gradually slanted.

The tower leans because the foundation is originally half rock

and the other half is on soil. In 1957, efforts were made to stabilize

the tower and prevent further leaning. Concrete was also pumped

into the soil forming a stronger foundation.

→ http://en.wikipedia.org/wiki/Huqiu_Tower

Any questions: write to keijihagiwara@gmail.com

Silk embroidery, Suzhou(刺繍，蘇州）

Suzhou has also been an important centre for China's silk industry and
continues to hold that prominent position today.

Below the works of Silk embroidery

really embroidery?     its photo.

photographic embroidery !

Famous poem in Hanshan Temple, Suzhou

Hanshan Temple is famed in East Asia because of the poem "A Night Mooring

by Maple Bridge" (楓橋夜泊), by Tang Dynasty poet, Zhang Ji.

The poem describes the melancholy scene of a dejected traveller, moored at night

at Fengqiao, hearing the bells of Hanshan Temple:

月落烏啼霜滿天，(Yuè luò wū tí shuāng mǎn tiān),

in English (While I watch the moon go down, a crow caws through the frost);

in Japanese; 月落ち烏（からす）啼きて霜天に満つ

江楓漁火對愁眠。(Jiāng fēng yú huǒ duì chóu mián).　

in English (Under the shadows of maple-trees a fisherman moves with his torch)　

in Japanese ; 江楓（こうふう）漁火愁眠に対す。

姑蘇城外寒山寺，(Gūsū chéngwài Hánshán Sì), 　

in English (And I hear, from beyond Suzhou, from the temple on Cold Mountain)

in Japanese; 姑蘇（こそ）城外の寒山寺

夜半鐘聲到客船。(Yèbàn zhōngshēng dào kèchuán).e

in English (Ringing for me, here in my boat, the midnight bell)

in Japanese; 夜半の鐘声客船に到る。

The poem is still popularly read in China, Japan and Korea. It is part of the

senior high school curriculum in both China and Japan. The ringing of the

bell at Hanshan Temple on Chinese New Year Eve is a major pilgrimage

and tourism event for visitors from these countries.

Any questions; write to keijihagiwara@gmail.com