1.Improvement of A Simulator Production Project for Abdominal Palpation in Kampo Medical Training
Shuji YAKUBO ; Yuko KINOSHITA ; Tatsuhiko AKI ; Hiroshi OTA
Kampo Medicine 2008;59(4):595-600
In Kampo medicine, sickness is regarded as affecting the whole body even though the symptoms may appear obvious only in the abdomen. This makes abdominal palpation an important means of physical examination, and diagnosis. Because learning abdominal palpation in the Kampo style is very difficult, we attempted to simplify learning by building typical anatomical abdomen models for training. To create six abdominal models : Shinka-hiko, Kyokyo-kuman, Fukuchokukin-renkyu, Shofuku-fujin, Shofuku-koman, and Shinkabu-sinsuion, we employed several materials, including artificial leather for epidermal tissue, pile fabric for subcutaneous tissue, cotton cloth or jersey cloth for membrane tissue, polyurethane or natural rubber for muscle tissue, specialized polyester resin for costae, and cotton for internal organs. We employed a harder polyurethane, for example, in Shinka-hiko to simulate resistance in the region beneath the heart, in Kyokyo-kuman to simulate resistance in the subcostal region, and in Shofuku-koman to simulate horseshoe-shaped resistance in the lower abdominal region. Otherwise, in Shofuku-fujin, a lack of resistance was simulated by a defect in the polyurethane at the center of the lower abdominal region. Shinkabu-sinsuion was modeled using a water dabbling sound via a water-filled balloon that could be gently shaken with the fist in the region above the navel. Fukuchokukin-renkyu was modeled as excessive strain of the rectus abdominis muscles via the use of natural rubber. We tried to represent the tenderness on pressure at the para-umbilical region, cecal region, and sigmoid region in the Shofuku-koman model by making a specialized switch with conducting rubber, and using electric device and battery. We believe these models are useful teaching devices, in that they simplify Kampo abdominal palpitation training.
Medicine, Kampo
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Cancer resistance to treatment
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Training
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Tissues
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Palpation
2.Insight for Oketsu Syndrome
Kampo Medicine 2007;58(3):423-426
The diagnostic criteria for oketsu syndrome which was proposed by K. Terasawa et al. High scores in paranavel resistance and tenderness was characteristic in it. It's evidence was obtained by that blood viscosities of oketsu patients increased than ones of non-oketsu patients. The numbness of seven patients with cerebrovascular accidents in fourteen patients were improved following the four weeks of administration of keishibukuryogan. In this study we could also recognize improvement of intra-vascular erythrocyte aggregation in their conjunctival microcirculation by using the video-microscopic system. These studies had been clarifying that oketsu state might be accompanied to microcirculatory distubance and kampo prescriptions treated for oketsu syndrome could improve it. Important point in using these prescriptions under the traditional standard is to check kyojitsu (robust or asthenia), face color (red or pale) and constipation/or not. I emphasized that role of checking kyojitsu might be bigger in prevention from the adverse effects than in searching drug to treat patient's illness.
Syndrome
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seconds
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Insight, NOS
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Cancer resistance to treatment
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Prevention
4.Detection of insecticides resistance status in Culex quinquefasciatus and Aedes aegypti to four major groups of insecticides.
Sunaiyana Sathantriphop ; Pungasem Paeporn ; Kasin Supaphathom
Tropical biomedicine 2006;23(1):97-101
The resistance to various insecticides from 4 major groups (organochlorine, organophosphate, carbamate and pyrethroid) was investigated in a field strain of Culex quinquefasciatus from Baan Suan community, Nonthaburi province, Thailand by using a standard World Health Organization susceptibility test. The Baan Suan strain was completely resistant to DDT and highly resistant to deltamethrin, permethrin, fenitrothion and propoxur but this strain was still found to be highly susceptible to malathion. This strain displayed high resistance to cypermethrin since the result revealed that the resistance ratio of the 50% lethal concentration value (RR50) between the field and the laboratory strains (NIH strain) was 16. The study indicated that mosquitoes were resistant to almost all insecticide tested except malathion and this should be an alternative for Cx. quinquefasciatus control in this area. Moreover, Aedes aegypti, which is a main dengue vector in Baan Suan community was also tested with deltamethrin, permethrin and fenitrothion. The results showed that dengue mosquitoes are clearly resistant to permethrin and tolerant to deltamethrin, but was 100% susceptible to fenitrothion. The cause of insecticide resistance in Cx. quinquefasciatus may be due to the continuous use of insecticide for dengue vector control programme in Baan Suan community.
Insecticides
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Cancer resistance to treatment
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Aedes aegypti
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Culex quinquefasciatus
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Permethrin
5.Insecticide resistance development in Culex quinquefasciatus (Say), Aedes aegypti (L.) and Aedes albopictus (Skuse) larvae against malathion, permethrin and temephos.
Hidayati Hamdan ; Mohd Sofian-Azirun ; Wasi Ahmad Nazni ; Han Lim Lee
Tropical biomedicine 2005;22(1):45-52
Laboratory-bred females of Culex quinquefasciatus, Aedes aegypti and Aedes albopictus from the insectarium, Unit of Medical Entomology, Institute for Medical Research were used in the experiment. The late third stage of the F0 larvae which survived the high selection pressure of malathion, permethrin and temephos were reared and colonies were established from adults that emerged. Cx. quinquefasciatus larvae were subjected to selection by malathion and permethrin for 40 generations, Ae. aegypti larvae to malathion, permethrin and temephos for 32 generations and Ae. albopictus larvae were selected against malathion and permethrin for 32 generations and 20 generations against temephos. The rate of resistance development was measured by LC50 value. Cx. quinquefasciatus larvae developed higher resistance to malathion and permethrin compared to Ae. aegypti and Ae. albopictus. On the whole, permethrin resistance developed at a faster rate than malathion and temephos.
Permethrin
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Malathion
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Cancer resistance to treatment
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Aedes aegypti
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Aedes albopictus
6.Biochemical detection of pyrethroid resistance mechanism in Aedes aegypti in Ratchaburi province, Thailand.
Pungasem Paeporn ; Kasin Supaphathom ; Raweewan Srisawat ; Narumon Komalamisra ; Vanida Deesin ; Phubeth Ya-umphan ; Somjai Leeming Sawat
Tropical biomedicine 2004;21(2):145-51
The emergence of insecticide resistance in mosquito vectors was an important issue to be considered as one of factors influencing the success of vector control. The early detection of resistance could help the health personnel to plan and select appropriate alternative control measures or insecticide for effective control. Therefore biochemical assay of enzymes in mosquito was conducted to detect the emergence of insecticide resistance and to define the machanisms involved in pyrethroid resistance. Adults of Aedes aegypti from two localtities in Ratchaburi province were subjected to permethrin and deltamethrin selection in laboratory. After three generations of selection, permethrin-selected and deltamethrin-selected strains were established. Their LT 50 increased to 7.46 and 1.18 folds in the F3 strains that were selected with permethrin and deltamethrin respectively. The enzymes of these mosquitoes were assayed biochemically to study the mechanisms of resistance. The results revealed significant increase of esterase activity and monooxygenase levels in both strains when compared with labolatory susceptible strain. Glutathione-S-transferase activity was found to increase in permethrin-selected strain but not in deltamethrin-selected strain. This suggested that not only esterase and monooxygenase but also glutathione-S-transferase were associated with permethrin resistance in Ae. aegypti. The exposing of permethrin-selected and deltamethrin-selected mosquitoes to diagnostic concentration of permethrin (0.75%) and deltamethrin (0.05%) indicated no cross resistance for permethrin to deltamethrin while slight cross resistance from deltamethrin to permethrin was evident. It seemed that glutathione S-tranferase was not associated with cross resistance since its activity in deltamethrin-selected strain remained unchanged as compared with that of laboratory susceptible strain.
Cancer resistance to treatment
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Permethrin
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decamethrin
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Culicidae
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Pyrethroid insecticide
7.Insecticide susceptibility and selection for resistance in a population of Aedes aegypti from Ratchaburi province, Thailand.
Pungasem Paeporn ; Phubeth Ya-umphan ; Kasin Supaphathom ; Pathom Savanpanyalert ; Pimpa Wattanachai ; Rasana Patimaprakorn
Tropical biomedicine 2004;21(2):1-6
The insecticide susceptibility of Aedes aegypti larvae and adults from four areas of Ratchaburi Province, Thailand was investigated using World Health Organization standard procedures. The larvae of Ae. aegypti in all areas were found to be susceptible to temephos. The strain with the highest level of temephos resistance was subjected to temephos selection. The resistance ratios increased to 2.74-fold from their parental non selected strain after 5 generations of selection. For the adult of Ae. aegypti, the study was conducted to determine the effects of 0.75 % permethrin and 0.05 % deltamethrin impregnated paper selection on the strain having the highest with the highest LT50 level. The results showed the increase in the LT50 to 7.46 and 1.18-fold after the third selected generation with 0.75 % permethrin and 0.05 % deltamethrin respectively. Mortality rates after exposing adults to discriminating concentrations showed that field populations in Ratchaburi Province were resistant to permethrin and deltamethrin. Alternative non-chemical measures need to be used in new of the emergence of resistance in the mosquito population.
Cancer resistance to treatment
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Selection (Genetics)
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Aedes aegypti
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Permethrin
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decamethrin
8.Parasitological and clinical efficacy of standard treatment regimens against Plasmodium falciparum, P. vivax and P. malariae in Papua New Guinea.
Blaise Genton ; Kay Baea ; Kerry Lorry ; Meza Ginny ; Brett Wines ; Michael P Alpers
Papua and New Guinea medical journal 2005;48(3-4):141-50
Resistance of Plasmodium falciparum (Pf) and P. vivax (Pv) to standard antimalarials is widespread in Papua New Guinea (PNG). The objective of the study was to assess the rate of clinical treatment failure (TF) and parasite resistance to amodiaquine (AQ), chloroquine (CQ) and quinine+sulfadoxine/pyrimethamine (Q+SP) for malaria in a rural health centre of the East Sepik Province. 179 patients presenting with symptoms and signs of malaria and with Pf (144 patients), Pv (18 patients), P. malariae (Pm) (7 patients) or mixed infection (10 patients) were included. 86 were treated with AQ, 88 with CQ and 5 with Q+SP. 21/179 patients (12%) were not cured or had a recrudescence of symptoms associated with parasitaemia in the 28 days following treatment, 14% after AQ, 10% after CQ and 0% after Q+SP. The proportion of TF was higher (17%) when the analysis population included only the 108 subjects who had a complete follow-up, especially for failure with Pf following AQ treatment (26%). During the 28 days of follow-up, RII or RIII level of resistance in Pf was detected in 55% of the subjects treated with amodiaquine, 30% of those treated with chloroquine and 0% of those treated with quinine+SP. Of the Pv or Pm parasites only one Pv was found to be RII resistant to CQ in the 28-day test. In vitro resistance of Pf to CQ was higher than to AQ (50% versus 27% of 36 parasite samples that grew successfully). The level of TF and parasitological resistance to standard antimalarial drugs was lower in this area than in urban settings, where drugs are more easily available. AQ performed less well than CQ but the difference is likely to be due to the age of the users, ie, their level of immunity, AQ being the first-line drug for young children. These results provided support for the recent change in the policy for the standard treatment of uncomplicated malaria in PNG from AQ or CQ to the combination of AQ+SP or CQ+SP, a recommendation aimed at slowing down the spread of multidrug resistance.
upper case pea
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Status post
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therapeutic aspects
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Cancer resistance to treatment
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Upper case queue
9.Antimicrobial susceptibility of community-acquired uropathogens in general practice.
Keah Say Hien ; Wee Eng Chye * ; Chng Kooi Seng ** ; Keah Kwee Chu
Malaysian Family Physician 2007;2(2):64-69
Antibiotic resistance of urinary tract pathogens has increased worldwide. The purpose of this study is to provide information regarding local resistance pattern of urinary pathogens to the commonly used antibiotics. One hundred and seventeen cases of community-acquired urinary tract infections were studied. The most common group of patients was the uncomplicated acute cystitis in women. E. coli was the most common isolate. Overall, antimicrobial susceptibility test on the organisms isolated showed a resistance of 63.0% to ampicillin, 40.1% to sulfamethoxazole-trimethoprim (S-T), 14.3% to pipemidic acid, 8.6% to norfloxacin, 3.8% to cephalexin, 3.7% to amoxicillin-clavulanate, 1.0% to cefuroxime, and 1.0% to fosfomycin. Three out of five patients on ampicillin as well as two out of five patients on S-T were likely to be inadequately treated.
Cancer resistance to treatment
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Community
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Upper case tea
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Upper case ess
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Antimicrobial susceptibility