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Primary ankylosing spondylitis: patterns of disease in a Brazilian population of 147 patients.

OBJECTIVE: To analyze patterns of disease in a population of Brazilian patients with primary ankylosing spondylitis (AS). METHODS: Retrospective study (1988-98) analyzing 147 patients with a diagnosis of primary AS according to the modified New York criteria. Selected patients had complete clinical (initial symptom, axial and peripheral involvement, heel enthesitis, extraarticular manifestations) and radiological (sacroiliac, lumbar, thoracic, and cervical spine) investigations, and these data were compared with sex, race, age at onset, and HLA-B27. RESULTS: There was a predominance of men (84.4%), Caucasian race (75.5%), adult onset (> 16 years, 85%), and positive HLA-B27 (78.2%). Family history of AS was noted in 14.3% of the patients. Pure axial AS was observed in 37 patients (25.2%). The predominant initial symptoms were inflammatory low back pain (61.9%) and peripheral arthritis (22.4%). Thoracic and cervical spine involvement was noted in 70.1% of the patients; radiological findings included syndesmophytes in 46.9% and "bamboo spine" in 20.4% of patients. The extraaxial joints most frequently involved were: ankles (39.5%), hips (36.1%), knees (29.3%), shoulders (19%), and sternoclaviculars (14.3%); heel enthesitis was present in 22.4%. Acute anterior uveitis was noted in 14.3% of patients. Male sex was associated with involvement of thoracic spine (p = 0.002), cervical spine (p = 0.002), and hips (p = 0.042), whereas female sex was associated with sternoclavicular (p = 0.024) involvement. Caucasian race presented higher frequency of positive family history (p = 0.023); there was no statistical significance of clinical and radiological variables compared with African-Brazilians. Juvenile onset AS presented higher frequency of ankle (p = 0.012) and knee (p = 0.001) involvement, heel enthesitis (p = 0.001), and total hip replacement (p = 0.038), whereas adult onset was associated with thoracic (p = 0.026) and cervical spine (p = 0.026) involvement and positive family history (p = 0.044). Positive HLA-B27 was associated with ankle involvement (p = 0.007) and heel enthesitis (p = 0.013). CONCLUSION: In this population women showed a milder axial involvement, Caucasian race presented axial and peripheral involvement similar to African-Brazilians, juvenile onset AS was associated with articular involvement of the lower limbs, and positive HLA-B27 was associated with ankle involvement.

Adolescent↗

Spider prey (Araneae) of Trypoxylon (Trypargilum) rogenhoferi (Hymenoptera: Sphecidae) in southeastern Brazil.

Fifty five nests and 216 cells of Trypoxylon (Trypargilum) rogenhoferi were obtained from trap-nests (cut bamboo canes) in Santa Carlota Farm (Itaoca Section = IS and Santana Section = SS), Cajuru and on the São Paulo University Campus, Ribeirão Preto (= RP), both in the State of São Paulo, Brazil (Sept. 1993-Oct. 1995). The prey (spiders) of 40 cells from IS, 58 from SS and 39 from RP were identified. The greatest nesting frequency occurred during the hot and wet season (September to April). T. rogenhoferi preyed upon individuals of five spider families, with Araneidae (orb-weaver spiders) being the most frequent (99.6%). Alpaida aff. negro (58%) was the most frequently collected species in IS, followed by A. alto (24.8%); in SS (59.6%) and RP (64.7%) the most frequent species was A. veniliae, followed in SS by A. aff. negro (14.9%) and in RP by A. leucogramma (13.5%). The size of reproductive niches, H' = 1.25 (IS), H' = 1.30 (SS) and H' = 1.29 (RP) were not significantly different. There was a positive correlation between the reproductive niche width (H') and evenness.

Animals↗

Polymicrobial outbreak of intermittent peritoneal dialysis peritonitis during external wall renovation at a dialysis center.

OBJECTIVE: To investigate an outbreak of peritonitis in intermittent peritoneal dialysis (IPD) patients. DESIGN: An outbreak investigation was performed to identify the etiology of the polymicrobial outbreak, and a retrospective case-control study was conducted to assess the risk factors for development of peritonitis. SETTING: Renal dialysis center. PATIENTS: Ten episodes of peritonitis occurred in 8 of 61 patients over a 6-month period in which 669 IPD procedures were analyzed. INTERVENTIONS: Field visit to renal dialysis center to examine the entire IPD procedure, inspect the hospital environment, and perform air bacterial count. MAIN OUTCOME MEASURES: The environmental factors and risk factors contributing to the polymicrobial peritonitis outbreak in IPD patients. The incidence of IPD peritonitis was determined before and after interventions. RESULTS: The causative organisms included Acinetobacter baumanii (6), Stenotrophomonas maltophilia (2), Pseudomonas aeruginosa (1), Candida albicans (1), C. tropicalis (1), Enterococcus (3), and Enterobacteriaceae (2). Four episodes of peritonitis involved infection by more than one organism. Air sampling of the environment detected a median of 110 colony forming units of bacteria per cubic meter of air, 10% of which were found to be Acinetobacter baumanii. The source of this polymicrobial outbreak was attributed to the bamboo scaffolding structure covering the external wall of the hospital during renovation. A retrospective case-control study indicated that the absence of the flush-before-fill step was a risk factor for development of peritonitis. CONCLUSION: In addition to invasive aspergillosis in transplant or oncology patients, Acinetobacter peritonitis in dialysis patients should be considered another microbial cause of outbreak associated with hospital renovation.

Aged↗

[Studies on the medicinal plants in the "Sambutsu-cho" of Merayama, belonging to Kuma province, Higo].

The Sambutsu-cho, a list of the natural products, of Merayama, belonging to Kuma Province, Higo was dedicated to the Tokugawa shogunate ca. 1735. This book did not contain so many names, but there were various names of plants, animals and minerals. In the plant kingdom, there were the names of the wild and cultivated plants, such as cereals, vegetables, fruits, trees, bamboos, herbs and mushrooms. The part on trees had 61 names and the other part, on herbs, had 76 names. In this report, I studied the species of the trees and herbs which were listed by their local and standard names. I identified them and found 56 and 63 species, respectively. Among the 56 species of trees, 39 were medicinal plants. Also, 48 medicinal plants were found among the 63 species of herbs. The ratio of medicinal plants to trees and herbs was 70 and 76%. This Sambutsu-cho contained color illustrations of the herbs, trees, animals, birds and insects. These pictures were not always accurate but very much useful to identify the local names in the Edo-period to match them with their scientific names. One of the most interesting samples was "Miso-ushinai." This was identified as Lyonia ovalifolia var. elliptica, Ericaceae.

Books, Illustrated↗

[The names of drugs in the cassia-bark family in China prior to the 11th century--On the standardization as Guizhi by Ling Yi and other scholars of cassia-bark family drug names appearing in the medical works written by Zhongjing].

The Chinese medical classics Shangham Lun, Jingui Yaolue and Jingui Yuhanjing are regarded as having been written by Zahn Zhongjing in the early part of the third century A.d. However, all current editions of the three works are based on the northern Song edition revised by Lin Yi and other scholars that was first published in 1065 and 1066. Guizhi appears in prescriptions in all three books as an important medicine. Yet whereas in the Chinese Pharmacopoeia (C.P.) Guizhi is defined as the Cinnamomi Ramulus (the whole twig), in the Japanese Pharmacopoeia (J.P.) it is defined as the Cinnamomi Cortex (the bark). The reasons for this difference between China and Japan has not been studied before. The author conducted a historical analysis of the terms and materials used for cinnamomic medicine in China from the third century B.C. to the year 1066, and the following results were obtained. (1) Until the Han period, the drug name Gui was commonly used for products made from the bark (the cork from the bark being removed) of cinnamomic plant. Such products have been excavated from a tomb where they were interred in the second century B.C., and the drug name Guixin was commonly used for them until the Tang period. (2) The terms Gui, Qin, Mugui, Mugui, guirou, Rougui, Guixin, and Guizhi found in medical texts up to the tenth century were all used for the products made from the bark. The Tang government's pharmacopoeia of 659, the Xinxiu Bencao, designates their material plant as either C. cassia or C. obtusifolium. This product primarily corresponds to Cinnamomi cortex, being Keihi in J.P. or Rougui in C.P. (3) The term Jungui was used from the third century B.C. for products in the shape of a bamboo pipe which were made from the bark of cinnamomic plant twig that had been repeatedly rolled up, and which were used as dietary foods or spices. The Xinxiu Bencao designates the material plant as C. burmanni, and the product corresponds to the cinnamon sticks now in use. (4) As to use Guizhi as decoction, we cannot deny the possibility that in the original medical works of Zhongjing there was a prescription by the name of Guizhi Tang. However, there are no examples of the drug name Guizhi until the sixth century, and most prescriptions of Zhongjing that were used around the Tang period employ Guixin or Gui. Because of this, in some prescriptions there has arisen a contradiction in the terminology; for example in Guizhi Tang, Guizhi might be prescribed instead of Guixin. Further, there are also prescriptions named Guixin... Tang. On the other hand, no evidence has been found that the whole twig of cinnamomic plant was used as a drug prior to the eleventh century. Consequently, this indicates an extremely small likelihood that in the time of Zhongjing the drug name Gizhi was employed, or that the whole cinnamomic twig was employed as a drug. (5) In the Taiping Shenghifang which was published in the early part of northern Song period there is, among the prescriptions for Guizhi, and example drawn from the prescriptions of Zhonjing, of the use of a drug named Guizhi, which has the same meaning as Guixin. However, at the time Gixin was a commonly used term.

Cassia↗

The history of cupping therapy.

As an important and integral part of non - drug folk therapy on TCM, there were also many other names for cupping therapy, such as "horning", "needlehorn", "sucking method", "fire - cupping", "boiling bamboo cylinder". By textual investigation, considerable clear recognition can be reached on the names, cupping instruments, cupping measure, indications and contradictions in different historical stages. Presently, cupping therapy is combined with other measures, such as drug therapy, acumoxibustions etc. In recent years, multi - functional vacuum cupping devices made of high - technical materials mark a great leap forward of the features of cupping devices and sucking measures.

China↗

[A brief history of succession of Xiaoshan Mt. Zhulin temple's discipline of women's diseases in modern time].

The Zhulin (Bamboo Forest) Temple was established in the southern Qi Dynasty. Buddhist monks in the Temple began their study on TCM in the 8th year of Tianfu reign of the Later Jin dynasty. However, it was not until the 6th year of Shaoding reign in Southern Song dynasty that it was named "King of Medicine" and became world famous. Records on the temple's geneology tree showed that the succession ended at Jinxiu, the 106th generation, who resumed his secular life. The thousand - year old temple was thus dismantled severely with no trace of ruins. Due to fire, war and artificial factors, since the leath of Xu Hui, this Discipline of Women's Diseases was succeeded by his son until now, there are still successors. Recently, the Discipline is characterized by its systematization of secret recipes, academic exploration and specific out - patient department with advances in the newly application of secret recipes.

Buddhism↗

[Causes of death of the host of no. 2 Chu Grave in Baoshan, Jingmen, Hubei Province: a preliminary study].

On the bamboo slips found in the No. 2 Chu Grave unearthed in Baoshan, Jingmen, Hubei Province in 1986, there were records about its host, Shao Tuo, consulting a sorcerer for his disease from March 4 (Chu Calendar) 317 B.C. to May 7th (Chu calendar), 316 B.C. As a result of textual research on the name of disease recorded as heart disease, lower heart disease and abdominal heart disease; the symptoms such as short breath, upper abdominal distension and dropsy; the characteristics of the disease such as sudden and intermittent onset, more and more severe condition, relatively rapid death and so on, it is considered that Shao Tuo died of cardiac disease. The two possible reasons why Shao Tuo suffered from cardiac disease are also discussed.

China↗

[Studies on the medicinal plant in the "Sambutsu-cho" of Bungo Province possessed by the Kumamoto Clan (I) Studies on the medicinal trees].

The Samabutsu-chou, a list of the natural products, of the Kumamoto clan in Bungo Province was dedicated to the Tokugawa shogunate in 1735. This book had many names of the plants, animals and minerals. In the plant kingdom, there were many names of cereals, vegetables, fruits, trees, bamboos, herbs, seaweeds and mushrooms. In this report, I studied the species of the trees which were listed by the Chinese and local names. I identified them and found 106 species. Among them, 68 species were medicinal plants. For example, the names of gardeniae fructus, forsythiae fructus, phellodendri radix and magnoliae radix were found as the famous medicinal plants. The ratio of the medicinal plants was 64%.

Botany↗

[Studies on the medicinal plant in the "Sambutsu-cho" of Higo Province possessed by the Kumamoto Clas (I): on the medicinal trees].

The Sambutsu-cho, a list of the natural products of the Kumamoto clan in Higo Province was dedicated to the Tokugawa shogunate in 1735. This book had many names of the plants, animals and minerals. In the plant kingdom, there were many names, wild and cultivated, of cereals, vegetables, fruits, trees, bamboos, herbs, seaweeds and mushrooms. In this report, I studied the species of the trees which were listed up by the Chinese names, Japanese standard and local names. I identified them and found 109 species. Among them, 67 species were medicinal plants. For example, the names of the crude drugs such as Gardeniae fructus, forsythiae fructus and phellodendri radix were found. The ratio of the medicinal plants was 61%.

Botany↗

Severe hypernatremic dehydration in an infant with Netherton syndrome.

Netherthon syndrome is a rare autosomal recessive disease characterized by ichthyosis, the characteristic hair abnormality trichorrhexis invaginata and atopic manifestations. We report a female child with the severe hypernatremic dehydration form of the Netherton syndrome born as the first child of consanguineous parents. Ichthyosis was present at birth. She was admitted to the intensive care unit at the age of 4 days with important loss of weight and dehydration. Severe hypernatremia and convulsions occurred. Despite intensive care the baby died at the age of 11 days. The diagnosis of Netherton syndrome was confirmed by the finding of the pathognomonic hair shaft anomaly trichorrhexis invaginata (bamboo hair) and premature lamellar body secretion and foci of electron-dense material in the intercellular spaces of stratum corneum as relatively specific markers for Netherton syndrome. Netherton syndrome is characterized by a large variability in phenotypic expression. The major neonatal complication is the hypernatremic dehydration, which can be fatal as in this patient or complicated by neurologic signs (intracranial hemorrhage) and secondary sequellae. Molecular studies revealed a mutation in SPINK 5, encoding a serine protease inhibitor. Prenatal diagnosis was performed in the second pregnancy and showed that the fetus was equally affected.

Carrier Proteins↗

[A cohort study on the relationship between vegetable intake and risks of lung cancer in the Tin Corporation (YTC) miners in Yunnan].

OBJECTIVE: To understand the relationship between vegetable intake and risk of lung cancer in the Tin Corporation (YTC) miners in Yunnan. METHODS: The reproducibility and validity of frequency of vegetable intake in Food Frequency Questionnaire (FFQ) were studied and the correlations between different vegetable intake and frequency and lung cancer relative risk among high risk population of lung cancer by Chi-square, single- and multi-Cox regression were analyzed. RESULTS: Results showed that the reproducibility and validity of wax gourd, cucumber, spinach, wild celery, fresh bush pepper, fresh soybean, sweet potatoes, asparagus, fresh bamboo shoot were good (r = 0.20 - 0.33, P < 0.05); There were significantly different incidences of lung cancer in different frequencies of wax gourd, cucumber, wild celery, fresh bush pepper out of 11 vegetables intake, and also in different total vegetable intakes (chi(2) = 8.83 - 30.64, P < 0.05). 11 vegetables and total vegetable intake were significantly negatively correlated with risks of lung cancer (RR < 1, P < 0.05). Only 2 vegetable frequencies were negatively correlated with risk of lung cancer by adjusting confounders such as age, occupational history, and smoking (P < 0.05). CONCLUSION: This suggested that vegetables intake may have a role in decreasing the incidence of lung cancer.

Adult↗

[The annotated research on "Xun du", "Xun li" as seen in excavation of the remains of Western Han dynasty].

The "Collected Notes of Armed Vehicles of 4th year of Wuku Yong shi" in Han bamboo slips excavated from the remains of Han tomb in Lianyungang, Jiangsu, carries a "Xun du", while a "Xun li" is carried in the Han record paper excavated in the remains of Xuanquan of Han, Dunhuang, Gansu. Both should be "frankincense", being the earliest record of this material, demonstrating that this medicine had been imported at least in early Western Han dynasty. Thus, the record of frankincense should be 300 years ahead of the existing record.

Archaeology↗

[Sulfation of polysaccharides isolated from Indocalamus tesselatus and their anticytopathic effect on human immunodeficiency virus type I].

For preparation of sulfated polysaccharides isolated from bamboo leaves (Indocalamus tesselatus) with chlorosulfonic acid-pyridine, the experimental conditions as the molar ratio of reactants and temperature and time of reaction were discussed. A homogeneous sulfation method with good yield of more than 80% was obtained and the sufur content was found to be 21.9%. Conformation change in sulfated polysaccharide with changes of intrinsic viscosity, polarimetery and CD spectra were found to be related to the negative charge. The polysaccharide sulfates were shown to have better activity to inhibit cytopathic effect of human immunodeficiency virus(HIV) infection than native polysaccharides. The effective concentration was 10 micrograms.ml-1 while the cytotoxic concentration was 2.5 mg.ml-1.

Antiviral Agents↗

The effects of substratum inclination on locomotor patterns in primates.

To explore the change from the horizontal quadrupedal walking to the vertical climbing in primates, I designed an experiment on an inclined substratum. The subjects were an adult male Japanese macaque and a 2-year-old female white-handed gibbon. The animals moved on a substratum made of bamboo pipe (8 cm diameter). The inclination of the substratum was changed from 15 degrees to 65 degrees in 5-degree increments for the Japanese macaque and from 20 degrees to 70 degrees with 10-degree increments for the white-handed gibbon. I placed surface electrodes and telemetry transmitters on the subjects to record the activity of the long head of the triceps brachii and the long head of the biceps brachii muscles. The Japanese macaque utilized horizontal quadrupedal walking until the incline was 15 degrees. Vertical climbing began at an inclination of 55 degrees. The intermediate locomotor mode was observed between 20 degrees and 50 degrees. The white-handed gibbon changed the locomotor mode from horizontal quadrupedal walking to vertical climbing at 40 degrees. I believe that the difference observed in locomotor mode between these two species was mainly due to differences in the intermembral index. The white-handed gibbon had a large intermembral index, which meant she had longer forelimbs and could therefore change locomotor mode at a lower inclination of the substratum.

Animals↗

[Netherton's syndrome in two sisters].

Two girls, sisters aged 4.5 years and 6 months, had experienced serious erythrodermia since birth, with scarcely any hair growth and they exhibited poor growth despite a hypoallergenic diet. On the basis of the dermatological condition ichthyosis linearis circumflexa and microscopic examination of a hair shaft in which trichorrhexis invaginata (bamboo hair) was observed, the diagnosis of Netherton's syndrome was established. In this autosomal recessive hereditary condition there is a defective production or maintenance of the stratum corneum. Apart from the skin and the hair abnormalities there is often an atopic constitution as well. The treatment consists of skin ointments and a high-energy diet due to the loss of protein via the skin.

Child, Preschool↗

Introduction of Aedes albopictus (Skuse) in southern California and potential for its establishment.

Isolated incidences of Aedes albopictus in the continental U.S. were reported as early as 1946 and the first incidence in California was reported in 1972. These introductions were referred to as "isolated incidences" because very few immatures were observed in used tires shipped from Southeast Asia. The first major discovery of a large population and subsequent establishment of Ae. albopictus in the U.S. was reported in 1986 from Houston, TX, in a shipment of used tires from Japan. In early June 2001, infestations of this species associated with containerized oceanic shipments of "lucky bamboo" (Dracaena spp.) packaged in standing water were introduced into southern California from mainland south China. Focal points of infestation are currently at the wholesale nurseries in southern as well as northern California. A control protocol for adulticiding and larviciding has been implemented by the Greater Los Angeles County Vector Control District. Surveys are presently being conducted by local vector control agencies in southern and northern California to determine the extent of infestation. Potential forAe. albopictus establishment is discussed.

Aedes↗

Sustainable regulation of construction.

The seminar examined the role building codes and regulations can have in promoting a more sustainable approach to construction, particularly through their application to non-industrial building materials. A range of building materials such as straw, bamboo, rammed earth, adobe, and cob (a mixture of clay and chopped straw) were described and illustrated by slides to show their building potential. The current codes have a prime concern to protect the health and safety of people from the built environment. They have been developed almost exclusively for mainstream industrial materials and methods of construction, which makes them difficult to use with alternative, indigenous, or non-industrial building materials, even though those materials may be considered more sustainable. The argument was put forward that with only one-third of the world population living in modern industrial buildings today, it is not sustainable to re-house the remaining rapidly expanding population in high technology dwellings. Many of the low technology building materials and methods now used by the majority of people in the world need only incremental improvement to be equal or superior to many of their industrial replacements. Since these can be more sustainable methods of building, there needs to be an acceptance of the use of alternative materials, particularly in the developing parts of the world, where they are being rejected for less sustainable industrial methods. However, many codes make it difficult to use non-industrial materials; indeed, many of the industrial materials would not meet the demands that must be now met if they were now being introduced as new materials. Consequently, there is a need to develop codes to facilitate the use of a wider range of materials than in current use, and research is needed to assist this development. Sustainable regulation should take into account the full range of real impacts that materials and systems have in areas such as resource use and depletion, toxicity of the processes that produce them, and their potential for re-use and recyclability.

Building Codes↗