24 February, 2010

White color stool in rotavirus infection

1) Watery stool of an infant with Roravirus's gastroenteritis(Vomiting & diarrhea) .
------- Stool colour is white-yellow, which is specific for Roravirus infection,
-------- since infection induce the reduction of bile excretion.

2) red colored ones are fragments of undigested carrot
3) Rapid test for rotavirus and adenovirus: red line show
--- the detection of rotavirus.

Rotavirus infection
❑Symptoms:------ fever and frequent vomiting, follow watery diarrhea.
❑Rotaviruses:----- 5 antigenic groups(A,B,C,D, E). Group A(6 serotypes)
---------------------- are major causes infantile vomiting & diarrhea.

Electron micrograph of Rotavirus. Bar indicate 100nm.
Dr. Maria-Lucia Rácz, Institute of Biomedical Sciences
University of São Paulo. Visual collection of American 

❑Transmission: ------fecal-oral route
❑incubation periods: 1-3 days
❑Treatment:---------- Oral rehydration solution or parenteral fluids
--------------------------are given to correct dehydration.

❑Prevention: ----------live attenuated vaccine(given by mouth).
--------------------------not available in Japan.

Any questions:   write to  Keiji Hagiwara, MD
-------------------------------  keijihagiwara@gmail.com
-------------------------------  Kami-Ube Pediatric Clinic,
----------------------------- --1-20-2 Tokiwadai, Ube 755-0097, Japan.

21 February, 2010

Dr. Kanehiro Takaki and vitamin B1 deficiency

Japanese rice: right is the polished rice(Bran, outer layer of rice,
which contain vitamin B1, E , are removed)

Kanehiro Takaki(高木兼寛 in Japanese) and beriberi

1)  Below are excepts from the book "Arthur Kornberg: For the love of
Japanese naval records of deaths from beriberi
Year               Diet               Total navy            Deaths from
                                             personnel                beriberi
1880(M13)     Rice diet          4,956-------------1,725
1881(M14)----Rice diet          4,641-------------1,165
1882(M15)----Rice diet          4,769-------------1,929
1883(M16)  -  Rice diet          5,346                     -1,236
1884(M17) Change to new diet  5,638                  718
1885(M18)----New diet--------6,918                        41
1886(M19)     New diet--------8,475                          3
1887(M20)     New diet--------9,106                          0
1888(M21)     New diet          9,184                          0

One hundred year ago, epidemics of beriberi(vitamine B1, or thiamine deficiency)
were destroying the Japanese navy. More than half of a crew, after a few weeks at
sea, would become weak, listless, and paralyzed and would succumb to profound
weight loss, liver disease, and heart failure.

Barely twenty-five years after Perry's visit, Japan had replaced Samurai swordsmen
with a navy that would soon challenge one of the mightiest of the West.  But unlike
Western sailors, the Japanese were peculiarly vulnerable to beriberi despite the best
hygiene and the finest rice money could buy; the kernels, having been separated
from the ugly husks, were polished free of the protective silvery skins consumed
by the population at home.

It struck one K. Takaki, a ship doctor, that the Japanese had copied every detail of
British naval equipment and operations excepts for rations, and so he designed this
crucial experiment: the crew of 300 of one vessel on a long cruise was fed the
polished rice diet, while the crew of another was given the unappetizing fare of
British seaman: oatmeal, vegetables, fish, meat, and condensed milk.

Of those fed with rice, two-thirds contracted beriberi; the sailors fed the strange
British diet all remained hale and hearty. The dramatic effects of changing to a new
ration are preserved in Japanese naval records(see Table). Although Dr.Takaki could
not explain the causal relationship between diet and beriberi, to knowledgeable
microbiologists in Japan and Europe these was only one interpretation: the polished
rice rations must have been infected.

2)  Dr. Takagi's effort of diet change was resulted in the dramatic decrease of
----vitamin B1 deficiency in Navy .  In Russo-Japanese war(1904-1905), Japanese 
----navy completely defeated the Russian Bultic Fleet in the Battle of Tsushima(Sea 
----of Japan Naval Battle).

----But not the diet change in Army were done. At that times,  medical community 

----, especially, doctors in Army believed that a bacteria is the cause of disease.  
----In fact, researchers of Tokyo Imperial college of Medicine insisted that we
--- found the beriberi's bacteria.

----During the Japanese Army Campaigns in Manchuria, China,  so many soldier were------
----suffering from Beriberi.  The vitamin B1 deficiency killed more soldiers than that
----of fighting itself.

3) Dr. Takagi also founded Ji-Kei University School of Medicine and nursing school
----at Tokyo. He studied the Medicine at St Thomas' Hospital in London and learned 

-    the pragmatic approach to the disease.

Any questions: write to Keiji Hagiwara, MD

----------------------------Kami-Ube Pediatric Clinic,
----------------------------1-20-2 Tokiwadai, Ube 755-0097, Japan
--------------------------- keijihagiwara@gmail.com

Drinks for acute gastroenteritis(vomiting & diarrhea) in children

OS-1: A solution for vomiting & diarrhea
----------- see→
Otsuka Pharmaceutical Factory , Inc.   

Oral rehydration solution

Oral Rehydration Solution(ORS) was first developed for infant diarrhea 
(acute gastroenteritis) in developing countries.  

The key point is  that absorption of water in intestine is associated 
with Na and glucose.

Oral Rehydration Solution( for example, OS-1 ) for children in developed 
countries contain lower concentration of Na & Cl than that of  ORS(WHO). 

               Na          K            Cl       citric acid----   glucose  (mmol/L)
WHO    75~90 --   20        65~80       10              75~111      

OS-1       50   -      20          50    ---       0                100

Any questions:  write to Keiji Hagiwara, MD                          

12 February, 2010

Tulips in Keukenhof

In 17th century, "Tulip mania "was occurred in Netherlands. 
A new variety, rare type, tulip bulb were trade with high prices. 
In addition, future market accelate the bulb prices.