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English Journal
- Validity of the Enzyme-linked Immunoelectrotransfer Blot (EITB) for naturally acquired porcine cysticercosis.
- Jayashi CM, Gonzalez AE, Castillo Neyra R, Rodríguez S, García HH, Lightowlers MW; Cysticercosis Working Group in Peru.Author information Veterinary Clinical Centre, The University of Melbourne, 250 Princes Hwy, Werribee, Victoria 3030, Australia. Electronic address: c.flores@uq.edu.au.AbstractThe Enzyme-linked Immunoelectrotransfer Blot (EITB) has been used widely as a screening test for Taenia solium cysticercosis in swine. However, the relation between seropositivity and infection in pig populations from endemic areas has not been well defined. The aim of this study is to relate EITB seropositivity with infection and infection burden, analyse the trade-off between sensitivity and specificity with various cut-off points for the EITB assay, and finally describe the serology changes in a cohort of rural pigs raised under natural conditions. A group of 107 pigs that were used as controls during a vaccination field trial in Peru was our study population. The prevalence of porcine cysticercosis determined by necropsy examination was 16.82% (18/107) in these animals. Using EITB reactivity to ≥1 band as a cut-off point for the assay, the sensitivity was 88.89% (65.29-98.62, 95% CI) and the specificity was 48.31% (37.59-59.16, 95% CI). Comparing other cut-off points, involving up to as many as 7 reactive bands, a reactivity of ≥3 bands provided the best trade-offs in sensitivity and specificity. Using this cut-off point for the assay, the sensitivity was 77.77% (52.36-93.59, 95% CI) and the specificity was 76.40% (66.22-84.76, 95% CI). A significant association was found between cyst counts over 100 cysts and reactivity to ≥3 bands in the EITB assay (Fisher's exact test, p<0.05). The results of this study suggest that the use of the EITB assay to study porcine cysticercosis may require setting different cut-offs under field and experimental conditions, and depending upon the objective of the screening process.
- Veterinary parasitology.Vet Parasitol.2014 Jan 17;199(1-2):42-9. doi: 10.1016/j.vetpar.2013.10.004. Epub 2013 Oct 16.
- The Enzyme-linked Immunoelectrotransfer Blot (EITB) has been used widely as a screening test for Taenia solium cysticercosis in swine. However, the relation between seropositivity and infection in pig populations from endemic areas has not been well defined. The aim of this study is to relate EITB s
- PMID 24183647
- Neurocysticercosis on 18F-FDG PET/MRI: Co-registered Images.
- Jolepalem P, Wong CY.Author information From the Department of Radiology and Molecular Imaging, Oakland University William Beaumont Health Systems, Royal Oak, MI.AbstractThis is a case of a 32-year-old female patient who presented with new onset partial complex seizures. MRI of the brain demonstrated a suspicious ring-enhancing lesion in the right temporal lobe. This finding was felt to be a primary brain malignancy or less likely an infectious process. F-FDG PET of the brain was able to exclude malignancy and provided evidence to support neurocysticercosis in the mesial temporal lobe as the cause for the patient's seizures. Neurocysticercosis is a neurologic infection caused by Taenia solium. It is rare in the United States and difficult to diagnose.
- Clinical nuclear medicine.Clin Nucl Med.2014 Jan;39(1):e110-3. doi: 10.1097/RLU.0b013e3182817ad8.
- This is a case of a 32-year-old female patient who presented with new onset partial complex seizures. MRI of the brain demonstrated a suspicious ring-enhancing lesion in the right temporal lobe. This finding was felt to be a primary brain malignancy or less likely an infectious process. F-FDG PET of
- PMID 23579982
- Prevalence of porcine cysticercosis and associated risk factors in smallholder pig production systems in Mbeya region, southern highlands of Tanzania.
- Komba EV, Kimbi EC, Ngowi HA, Kimera SI, Mlangwa JE, Lekule FP, Sikasunge CS, Willingham AL 3rd, Johansen MV, Thamsborg SM.Author information Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania. Electronic address: babagrid@yahoo.com.AbstractPorcine cysticercosis (PC) caused by the larval stage of a zoonotic tapeworm Taenia solium, is known to pose serious economic losses and public health risk among smallholder pig production communities. The present study was conducted to determine prevalence and associated risk factors for PC in smallholder pig production systems in Mbeya region, the major pig rearing region of Tanzania. A cross-sectional survey employing a random sample of 300 pig keepers from 30 villages of Mbozi and Mbeya Rural districts, Mbeya region were used to evaluate pig production systems and practices. Concurrently, 600 male and female pigs of different age categories were randomly selected and examined for PC using lingual examination method and antigen enzyme-linked immunosorbent assay (Ag-ELISA). The overall pig level PC prevalence in Mbozi district was 11.7% (95% CI=8.5-15.8%) and 32% (95% CI: 27-37.5%) based on lingual examination and Ag-ELISA, respectively. In Mbeya Rural district, the prevalences were 6% (95% CI: 3.8-9.3%) and 30.7% (95% CI: 25.8-36.1%) by lingual examination and Ag-ELISA, respectively. In Mbozi district 46% of the households were found infected (one or more infected pigs) and the corresponding figure was 45% for Mbeya Rural district. The agreement between lingual examination and Ag-ELISA was poor (κ<0.40). There were no significant differences in the prevalence of PC in different sex categories of pigs. Significant risk factors associated with PC prevalence were free roaming of pigs (OR=2.1; 95% CI=1.3-3.6; p=0.006), past experience of porcine cysticercosis in the household (OR=2.6; 95% CI=1.5-4.8; p=0.002), increased age of pig (OR=1.9; 95% CI=1.2-3.0), slatted raised floor in pig pen (OR=8.4; 95% CI=1.0-70.0), in-house origin of the pig (OR=1.6; 95% CI=1.1-2.5) and sourcing of water from rivers (OR=3.1; 95% CI=1.6-6.3; p<0.001) and ponds (OR=5.0; 95% CI=1.2-21.7; p=0.031). This study has clearly revealed a high sero-prevalence of PC in the study area, which imposes a major economical and public health burden to the smallholder pig farmers. The study also points to a number of important risk factors in smallholder pig management that may be addressed (e.g. confinement, quality of pens and water sources) in future interventions and educational campaigns for control of T. solium.
- Veterinary parasitology.Vet Parasitol.2013 Dec 6;198(3-4):284-91. doi: 10.1016/j.vetpar.2013.09.020. Epub 2013 Sep 28.
- Porcine cysticercosis (PC) caused by the larval stage of a zoonotic tapeworm Taenia solium, is known to pose serious economic losses and public health risk among smallholder pig production communities. The present study was conducted to determine prevalence and associated risk factors for PC in smal
- PMID 24139481
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★リンクテーブル★
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- attend
- vt.
- ~に出席/参列する、(学校に)行く(go toより堅い語)
- The normal ECG and chest X-ray when he attended hospital after an episode do not rule out an intermittent conduction problem.
- (結果として)~に伴う
- ~に同行/同伴する、付き添う、仕える。往診する。~の世話をする、~に気をつける、見張る
- vi.
- 出席/参列/出勤する(at)
- 留意/注目/傾聴する(to)。身を入れる、勢力を注ぐ、心を傾注する(to)。世話をする、気を配る(to)
- 仕える、付きそう(on)。(危険・困難などが)伴う(on)
- productive
- outflow
- obstruction
-
- the clinical picture suggests obstruction to outflow from the stomach.(この臨床像は胃流出障害を示唆している)
- obstruction to outflow
- 流出障害
-
- the clinical picture suggests obstruction to outflow from the stomach.(この臨床像は胃流出障害を示唆している)
- aqueous outflow from the eye (眼球からの房水流出)
- retain
- re + tent (tineo=teneo) = to hold back
- 保持する、保有する、保留する、持ち続ける、維持する。(使用のために)確保しておく
- (ある場所に)保つ、保持する。(熱などを)保っている、失わないでいる
- 忘れないでいる、覚えている
- (弁護士・気腫・召使いなどを)雇っておく、抱える
- 使用/実行し続ける。(廃止しないで)そのままにしておく
- palliation
- n.
- 寛解、緩和
- volvulus
- 腸捻転
- bezoar
- 胃石
- malrotation
- 腸回転異常
- intussusception
- 腸重積
- succussion
- n.
- 強く揺り動かすこと、強く揺れること
- splash
- n.
- はね返し、はねかけ。はねかす音。
- どっと流れる水。
- □unit
- 1 unit = 10 ml of ethanol
- □350ml アルコール5%
- 350x0.05/10=1.75 unit
- http://pohwa.adam.ne.jp/you/hobby/ryori/sake2.html
- 1unitの量が国によって違う。純エタノール換算で、1英unitは8g=10ml(英糖尿病協会採用の数値)、1米unitは15g(20ml弱:1drinkとも)で、日本では10~14g程度(代謝熱量80Kcalが基準:食品成分表5訂版,2002)や20ないし23g(日本酒1合分)を1unitとしている。日本の医学界では1unit=20g(体積に換算すると25ml)を採用することが多いので、ここでもそれに従う。この基準(1unit=20g=25ml)で計算すると、40度のウィスキー1ショット(=1オンス:英液量オンスで28.41ml、米液量オンスで29.57ml、日本の1ショットで30ml)が約0.5unitとなる。5度のビールなら500mlでだいたい1unit(この、日本酒1合≒ウィスキーダブル≒ビール500cc≒1unitという関係は、覚えておくと便利かもしれない:ワインなどは日本酒に準じるので、1本750mlがだいたい4unit強である)。
- 主訴:体重減少
- (主訴にまつわる症状)
- ・4ヶ月で10kg減少、食欲の減少、嘔吐(頻度:次第に増えてきている。嘔吐物と量:何時間も前に食べたものを多量に嘔吐する)
- (主訴以外の症状)
- ・一ヶ月前から脱力感(部位:特に下肢で著しい(丘に登ったり、階段を上ったりするとき))
- 嗜好歴:喫煙 20/day、飲酒 10units/week (ビール 6本弱)
- 家族歴:なし
- 既往歴:高血圧(2年間β遮断薬で治療、4ヶ月前に服薬中止)
- 身体所見 examination
- バイタル:82/分、血圧 148/86 mmHg
- 全身:やせ、体調が悪そう(unwell)。
- 呼吸器、心血管系に異常なし
- 腹部:腫瘤触知せず、圧痛なし、振盪音/振水音を認める
- 検査所見 investigations
- 低値:ナトリウム、カリウム、クロライド、尿素
- 高値:重炭酸
- Q
- 1. これらの所見の説明は?
- 2. もっともな診断は?
- A
- ★
- 胃流出路の閉塞 = 食後の嘔吐 + 胃の振水音
- 高BUN + 低CRE → 脱水
- 低Na,Cl,H+ → 嘔吐
- HClの喪失 → 代謝性アルカローシス
- H:細胞内→外
- K:細胞外→内
- 従って、低カリウム血症 → 筋力低下・脱力
- ★
- 胃流出路の閉塞の原因:胃癌とか胃潰瘍による瘢痕
- 診断には上部消化管内視鏡・生検(組織診)、その後にCT(局所浸潤、転移巣検索)
- 治療法:腫瘍だったら腹腔鏡による腫瘍の摘出術。その他の場合は手術をしたり、薬物療法をしたり、、、
- 学習ポイント
- ・嘔吐・嘔気 nausea and vomiting DIF.321, vomitus DIF.449 IMD.351
- 解剖で考えよう。縦に解剖、横に病因
- 鼻咽頭 扁桃、外来異物
- 食道 アカラシア、逆流性食道炎、食道癌 ・・・嚥下困難があるはず
- 胃 胃炎、消化性潰瘍、胃癌、幽門部の病変(ポリープ、癌、潰瘍;胃の出口を閉塞させる)。子供だったら幽門狭窄症
- 十二指腸:潰瘍、十二指腸炎、Billroth II法による輸出脚の閉塞、Billroth I/II法によるダンピング症候群。胆汁性胃炎も原因となる。
- 小腸:小腸閉塞(腸重積、腸回転異常症、胃石症、癌腫、限局性回腸炎)
- 結腸:潰瘍性大腸炎、アメーバ症、腫瘍男。腸間膜動脈血栓症、
- 消化管全体:Strongyloides, Ascaris, Taenia solium
- ・β遮断薬の服用中止で何が起こる?
- 狭心症や発作性の高血圧。
- なんでやめたんだろう? → 副作用:(1%程度に)めまい、全身倦怠感、頭痛、徐脈が出現
- ・振盪音
- 腹水や胃内容物の貯留によって聴取される。
- ・BUN高値、Cre低値
- suggest a degree of dehydration
・BUN
- ==検査値の異常 (異常値の出るメカニズム第5版 p.144)==
- ===BUN上昇===