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Per rectum: a history of enemata.

Enemas and clysters have been administered since before recorded history, using instruments ranging from cow horns and hollowed out bamboo shoots to metal syringes to inject laxatives, herbs, opium, turpentine, tobacco, oxygen and noxious chemicals. The potentially lethal dangers are today well recognised. The rectal route, now less often used for laxative enemas is still proving useful for other medications, increasingly in suppository form.

Administration, Rectal↗

[Okuda wooden human skeleton made in Edo era, Japan].

Probably in 1820 (late Edo era), a human skeleton for medical education was carved from cypress wood, based on a criminal's skeleton under the supervision of a medical doctor, Banri Okuda in Osaka City. The skeleton is called "Okuda wooden skeleton" and is now housed in the National Science Museum, Tokyo. The bones can be assembled into a skeleton by metal pivots or bamboo sticks. The thorax and pelvis were made of several pieces of wood and combined together, respectively. By and large, the wooden skeleton shows morphological characteristics usually seen in early middle-aged females of the Edo era. But the claviculae, distal ends of the femora, and the patellae are exceptionally larger than those of a female, implying that these bones of the original skeleton had already been lost or were deformed before the wooden skeleton was made. Actually the wooden skeleton might not have been used for medical education but rather for the promotion of European medicine, which was gradually developing in the Edo era.

Anatomy↗

[Impacts of different vegetation types and soil properties on runoff chemical characteristics].

Chemical characteristics of surface runoff and groundwater in different vegetation types on Jinyunshan located in suburb of Chongqing were studied, and the relationship between runoff chemical characteristics and soil properties were analyzed. The vegetation types include coniferous broad-leaved mixed forest, evergreen broad-leaved forest, bamboo forest, shrubbery and bare soil. Results showed as follows: Chemical characteristics in surface runoff and groundwater were similar to that in rainfall, which Ca2+ was the dominant cation, Ca2+ > K+ > Na+ > Mg2+ > NH4+; and SO4(2-) was the dominant anion, SO4(2-) > NO; > Cl-. The concentration of Ca2+, Mg2+, K+, Na+, SO4(2-), Cl- in runoff were higher than that in rainfall, meanwhile Ca2+, Mg2+, SO4(2-), Cl- in groundwater were higher than that in surface runoff. pH of groundwater was obviously influenced by soil pH. Ca2+, Mg2+, K+, Na+ in groundwater showed a negative correlation to those properties in soil profile because cations were always absorbed by colloids in soils. Moreover, since anions were easy to be leaching, SO4(2-), NO3-, Cl- in groundwater displayed a positive correlation to that in soil profile.

Calcium↗

[Differentiation and analysis of original meaning of classical channel theories].

OBJECTIVE: To probe into the original meanings of manifestation and root cause, root and knot, Genliu infusion, Benshu, pathway of qi, four sea, Guan-He Shu and other classical channel theories. METHODS: Based on Huangdi Neijing (The Yellow Emperor's Internal Classic) and other classical literatures, combined with medical books in bamboo slip and the silk and opinions of annotation experts of successive dynasties, deeply analyze and study. RESULTS: Classical channel theories are involved in some theories of channel structures, with 3 original meanings: expounding the origin, the end and running of channels, expounding bi-directional running of channel-qi, and expounding the affinity relation of six channels, six qi, six zang-organs and six fu-organs. CONCLUSION: Classical channel theories stress emphasize concentric running of channels, and concentric arrangement of channel acupoints, bi-directional running of channel-qi, and each affinity of six channels.

Humans↗

Gut inflammation in the spondyloarthropathies: clinical, radiologic, biologic and genetic features in relation to the type of histology. A prospective study.

Ileocolonoscopy was performed on 354 patients with spondyloarthropathies. Histologically, the population could be divided into 145 patients with normal gut histology, 88 patients with acute inflammatory lesions and 121 patients with chronic inflammatory lesions. A number of clinical, biologic, radiologic and genetic variables were determined before ileocolonoscopy. Chronic gut lesions were associated with a family history of ankylosing spondylitis (AS) and Crohn's disease, several episodes of diarrhea, an increased stool frequency, elevated inflammatory serum variables, reduced axial mobility, the presence of sacroiliitis, bamboo spine, destructive joint lesions, a diagnosis of AS and HLA-Bw62 positivity. As the frequency of HLA-Bw62 is also increased in proven Crohn's disease, this would suggest that chronic gut lesions are related to this disease. Acute inflammatory lesions were related to a higher fecal carriage of specific bacteria and to the diagnosis of undifferentiated spondyloarthropathy, especially the enterogenic forms of reactive arthritis. Consequently, these lesions also appear to be related to a bacterially induced gut inflammation. Gut histology was normal in urogenital inflammation and urogenital reactive arthritis, suggesting a different portal of entry for antigens. The 3 histologic pictures of the gut (normal, acute and chronic) inflammation seem to correlate with different clinical, biologic and radiologic manifestations of the disease concept of spondyloarthropathies.

Adolescent↗

[Biological cycle of Aedes albopictus (Diptera, Culicidae), in the laboratory].

Twelve colonies of Aedes albopictus were maintained at laboratory conditions, with the following results: Insectary conditions--Air humidity: 90-95%; Temperature: 25 degrees C; Blood source: human; Breeding places: Plastic glass or bamboo; Number eggs per female: 36.37; Incubation time: 1 to 6 days; Larval period: 4 to 9 days; Pupal period: 1 to 5 days; Adults life span: females--30.8 days and males--26.6 days.

Aedes↗

The state of preservation of the cadaver of the Marquise of Tai found in the Han Tomb No. 1 in Mawangtui near Changsha as revealed by the fine structure of the muscle and other tissues.

The cadaver in the Han Tomb No. 1 at Mawangtui near Changsha, Human Province, excavated during the Great Proletarian Cultural Revolution and the movement to criticize Lin Piao and Confucius, is the remains of the wife of Litsang, the Marquis of Tai, the Chancellor of the principality of Changsha in the early Western Han Dynasty. The cadaver, buried underground for more than 2,100 years, is very well-preserved. The results presented in this paper are a part of the multidisciplinary investigations of the state of preservation of the cadaver, which, together with the studies of the pathological changes and the cause of death, and the attempts at unveiling the secret of preservation, constituted the main objectives of the coordinated research activities for the Han cadaver. This paper describes the fine structure of the muscle and other tissues of the cadaver. By an extensive analysis of the electron micrographs of the psoas muscle, by fractionation of various fragments of the same, and by simulation experiments with fresh human muscle incubated with cathepsins, it is possible to show that the muscle fibril assumes the shape of a bamboo shoot and is made up of a stack of alternate layers of two "half A disks" (one wing of the A cylinder minus the H zone) to one Z disk, held together by remnants of the microfilaments and wrapped up in the sarcoplasmic reticulum. The H zone of the A band and the I filaments have preferentially autolyzed. The best preserved portions of the Han muscle still retain antigenicity to a certain extent. The best-preserved of all proteins is collagen, retaining much of the macromolecular, chemical and biochemical characteristics, whereas pancreatic enzymes, cytochrome C and other stable proteins could no longer be detected. The separation of degradative processes into endogenous autolysis and exogenous putrefaction, the synthesis of the factor of macromolecular stability and the factor of autolytic environment, and the disentanglement of the changes occurring soon after death and the long-term gradual changes, have been discussed in an attempt to understand how the corpse changed in the course of time and why it was so well-preserved. The well-preservedness of the cadaver of the Marquise of Tai once again testifies to the creative wisdom of the labouring class of our ancestors.

Cathepsins↗

Aedes furcifer and other mosquitoes as vectors of chikungunya virus at Mica, northeastern Transvaal, South Africa.

From 1977 to 1981, studies were conducted on a farm at Mica where Aedes furcifer had been a vector during an epidemic of chikungunya virus in 1976 to determine whether the virus persisted in this mosquito, the likelihood of vertical transmission, and whether any other Aedes species could have been vectors. Aedes furcifer/cordellieri was the only prevalent tree hole Aedes which fed readily on monkeys and humans and occurred through the summer until the onset of winter. Virus was not isolated from 7,241 females and 4,052 males of this group, which were largely Ae. furcifer and which included a sample of the first post-epidemic population. Five additional Aedes species were prevalent in bamboo pots, 3 of which (Ae. aegypti, Ae. fulgens and Ae. vittatus) were shown to be competent laboratory vectors. Virus was not isolated from a sample of 13,029 such newly emerged mosquitoes representing the first post-epidemic population. It is concluded that Ae. furcifer is an epidemic-epizootic vector which does not maintain the virus at Mica and that no other mosquito species could have been important vectors.

Aedes↗

[Diagnostic value of magnetic resonance imaging for syringomyelia].

Ten cases of syringomyelia confirmed by magnetic resonance imaging (MRI) were presented. The cavities in the spinal cord were of low signal on T1 weighted image (T1WI) and high signal on T2 weighted image (T2WI). The segments of the spinal cord with involved lesion resembled "bamboo joints" or were of "beaded" shape on sagittal section image and of "necklace" shape on cross section image. Size of the lesions in the spinal cord shown by MRI was larger than that judged by clinical symptoms. MRI can clearly show the position, size and shape of the cavities and other abnormal conditions. Results of this study show that MRI is the most useful diagnostic tool for syringomyelia. It should be emphasized that there was no dissociated impairment of pain and temperature and touch sensation in 40% of the patients and chronic spontaneous segmental pain was one of the important clinical characteristics of syringomyelia.

Adult↗

[Netherton's syndrome].

A 10-year-old female patient with Netherton's syndrome is described, who developed characteristic symptoms: rounding linear ichthyosis, bamboo brittle hair and atopic dermatitis. Ten-week saturation of the body with vitamin A and other vitamins, therapy with immunostimulants and surface demulcents and exfoliating agents resulted in a considerable improvement of the patient's condition.

Child↗

Surveillance of neonatal tetanus in Thailand, 1977-1986.

Information on the morbidity and mortality of neonatal tetanus was reviewed to evaluate the impact of the immunization programme among pregnant women in Thailand from 1977. We also analysed the epidemiological characteristics of investigated neonatal tetanus cases during the period 1984-1986. The neonatal tetanus case rate declined from 72.1 per 100,000 livebirths in 1977 to 53.7 per 100,000 livebirths in 1986. Reduction in the incidence rate was inversely associated with increasing vaccination coverage of pregnant women with tetanus toxoid. The ratio of male to female neonatal tetanus was 1.5 to 1. Approximately 95 per cent of the cases occurred within the first 14 days of life, with the highest number recorded at 6-8 days of life. The majority of investigated cases were infants who became ill following delivery assisted by traditional birth attendants or relatives of mothers. About 88 per cent of these cases were infants whose mothers had no tetanus immunization. Razor blades and bamboo splits were the most frequently used instruments for cutting the umbilical cord. Strategies to control neonatal tetanus in Thailand should include immunization of pregnant women with tetanus toxoid, and more comprehensive training and supervision of untrained birth attendants.

Female↗

A variant of diffuse idiopathic skeletal hyperostosis: a case report.

The case of an elderly man with a bamboo-like spine is presented. Because the patient's osteoporosis prevented proper evaluation of the sacroiliac and apophyseal joints on plain radiographs, the case originally was misdiagnosed in an outpatient clinic as ankylosing spondylitis. A further work-up showed the integrity of the apophyseal and sacroiliac joints, as well as cortical hyperostosis of the midcervical spine consistent with the diagnosis of diffuse idiopathic skeletal hyperostosis (DISH).

Aged↗

Breeding places and seasonal incidence of Aedes aegypti, as assessed by the single-larva survey method.

The single-larva survey method was employed to study the breeding places and seasonal incidence of Aedes aegypti in Dar es Salaam, Tanzania. From May 1968 to May 1969, 28 462 containers of water-located in approximately equal numbers indoors and outdoors-were investigated. The highest frequency of breeding (8.0%) of A. aegypti was observed in tires and motor parts. Drums, barrels, water-pots, and other receptacles left outdoors showed a higher frequency (3.1%) than those kept indoors (0.6%). Metal containers were infested to a greater extent than those made of mud, wood, or other materials; 2.5% of coconut shells, snail shells, etc. and 1.3% of tree holes, plant axils, and cut bamboos were infested. The seasonal prevalence, expressed as a container index, closely followed and paralleled the fluctuations in rainfall. The value of this survey method for both ecological studies and practical control purposes is discussed.

Aedes↗

Incidence, clinical manifestation and general management of snake bites.

There are regional patterns in snake-bites. Bites by cobras have a high incidence in Thailand and in the Philippines with a high case fatality rate. Among the venomous snakes of haemorrhagic nature, bites by Trimeresurus species such as green pit viper, Taiwan habu and Taiwan bamboo viper are important in Thailand and Taiwan for their high incidence of bite, although the case fatality rates are low. Bites by Malayan pit vipers are also important in Thailand and Malaysia because of their high incidence. Bites by sea snakes are more common in Malaysia than in the Philippines and Thailand.

Animals↗

[The Netherton syndrome with alopecia and prolinuria].

A six month old boy under observation for over two years developed an ichthyosiform erythroderma with alopecia, which was diagnosed as Netherton syndrome. Histologic examination of the hair roots showed trichorrhexis invaginata (bamboo hair), trichorrhexis invaginata torta and pili torti. Prolinuria was detected. Local therapy with corticosteroids was without any effect. These symptoms can be attributed to aminoaciduria (prolinuria).

Alopecia↗

[Lethal osteogenesis imperfecta. Definition and heterogeneity].

The lethal form of osteogenesis imperfecta must be more clearly defined than it is. Early death of the child is not a sufficient criteria since it is observed in other forms compatible with survival. The authors therefore insist on the innumerable fractures of the ribs giving the particular aspect described as "bamboo ribs". These are observed in practically all cases. Heterogeneity however is undoubtful and an X-ray film is reproduced showing thin ribs without fractures in another exceptional lethal form. Genetic and very recent biochemical investigations suggest a new heterogeneity of the lethal form, even well defined clinically and radiologically. Contrary to earlier and frequent statements, it results most often from a dominant mutation, while recessive inheritance is much rarer, therefore the overall risk of recurrence much below 25%.

Female↗

Cultivation of two varieties of winged bean (Psophocarpus tetragonolobus, L. DC) in Jaboticabal, São Paulo.

Winged bean was recently introduced in the region of Jaboticabal, and the behavior of varieties "UPS-31" and "UPS-122" in different planting seasons was studied. Plantings were spaced 15 days, and the experiment started October 16, 1978 and ended December 15 of the same year. Plantings were made in rows, spaced 1.50 m from each other, leaving a distance of 0.60 m between plants. Their growth was tutored by bamboo poles which led them to a single wire placed horizontally at 1.70 m from the soil. An effect of the planting season was observed on flowering and fructification, since late plantings presented lower values for these characteristics and also decreased the harvesting period of the dry pods. Early plantings led to a higher development of the plants, and also to higher yield values as yield is a consequence of the number of pods per plant, with a high content of seeds per pod. Variety "UPS-122" was somewhat late in flowering and more vigorous than "UPS-31". The planting season did not affect the protein and oil contents, and average values in seeds of 43% and 17% were obtained, respectively.

Agriculture↗

[The Netherton syndrome: clinical characteristics, differential diagnosis and new ways of therapy].

The Netherton-syndrome is a rare disease which is probably inherited through an autosomal recessive trait. It is defined by a triad of symptoms: congenital ichthyosiform erythrodermia , trichorrhexis invaginata et nodosa ("bamboo hair") and atopy. Additional disorders affect the immune system, the metabolism of amino acids and the physical development. On the basis of a new case, the cellular immune defect and the genetic background of the disease are more clearly defined. A new form of treatment--a combination of photochemotherapy (PUVA) and systematic application of aromatic retinoid--has so far proved to be successful. In order to establish an accurate diagnosis--a prerequisite for this promising therapeutic approach--diseases with similar symptoms are discussed for comparison.

Child↗