October 1999 (1st half)

[To 2nd half]
  • Japanese in Medicine
    Today at the OHSU Library I came across a journal article about a condition I had never heard of before: Niikawa-Kuroki syndrome, or kabuki syndrome (KS), a rare malformation syndrome first reported in Japan in 1981. Individuals with KS have postnatal growth retardation, skeletal abnormalities, mental deficiency and characteristic dysmorphic features that result in peculiar faces that resemble the makeup of actors in kabuki, a kind of traditional Japanese theatre. You will not be able to diagnose this condition unless you are aware of this aspect of Japanese culture!

    Mhanni AA, Chudley AE. Genetic landmarks through philately - Kabuki theatre and Kabuki syndrome. Clinical Genetics 1999;65:116-117.

    In medicine, eponyms (names formed from or including a proper name) are overwhelmingly European, but there are a few Japanese names:

    • Moyamoya disease - occlusion of cerebral blood vessels; when visualized on angiography, the contrast media in the areas of neovascularization (new vessel formation) appears like hazy mist that Japanese gitai-go (mimesis - words that imitate actions or states) describes as "moyamoya".
    • Minamata disease - neurologic disorder due to mercury poisoning; prevalent in the 1950's and 1960's among those who ate contaminated seafood from Minamata Bay, Japan
    • Hashimoto thyroiditis - an inflammation of the thyroid gland
    • Katayama disease - infection with the liver fluke Schistosoma japonicum
    • Kawasaki disease - mucocutaneous lymph node syndrome
    • Kimura disease - an inflammation of lymph nodes
    • Oguchi disease - a form of hereditary night blindness
    • Takayasu arteritis - inflammation of blood vessels to the arms and head, leading to their progressive obliteration
    • Tsutsugamushi disease - scrub typhus, a self-limited febrile disease due to infection by Rickettsia tsutsugamushi
    • Harada syndrome - uveomeningitis, retinitis and skin changes
    • Chediak-Higashi syndrome - autosomal recessive leukocyte dysfunction
    • Kasai procedure - portoenterostomy to establish bile drainage in babies with biliary atresia
    • Shikata stain - a histochemical stain to identify hepatitis B virus
    • Nevus of Ota - a type of skin mole
    • Kamino bodies - these eosinophilic epidermal globules are apoptotic melanocytes, a histologic finding in some skin tumours, like Spitz nevus
    • Hirano bodies - a histologic finding in some brain diseases, like Alzheimer disease
    • Shimada index - a histologic grading schema for neuroblastoma, a type of cancer common in childhood
    • Fukuyama-type congenital muscular dystrophy - One of Japan's most common genetic disorders. Patients with this disease suffer from defects in neuronal growth during brain formation as well as progressive muscle degeneration. Researchers have linked it to a mutation in a gene on chromosome 9 that encodes fukutin, a protein involved in nervous system and muscle function. The mutation is apparently caused by a so-called retrotransposon, a roving snippet of genetic information copied into the chromosome 2,000 to 2,500 years ago. This is the first time a human genetic disorder has been linked to a retrotransposon.
    • Kasai procedure - A hepatoportoenterostomy, an operation developed by Dr. Morio Kasai, a Japanese surgeon, for pediatric patients with congenital biliary atresia
    (14 October 99)

  • Ricardo, Miriam & Fidel (Switzerland 1996; Dir: Christian Frei) ***
    A documentary about intergenerational issues in modern Cuba. As a young man, Ricardo fought alongside Fidel Castro and Che Guevera in the Sierra Maestra, helping with Radio Rebelde, whose broadcasts helped sway public opinion and win the revolution. Today, his daughter Miriam lives with food shortages and power blackouts, and listens to Radio Marti, an American radio station broadcasting at Cuba, named after the father of Cuban independence. We also see attempts by TV Marti to send information to Cuba, which are met with swift Cuban army counteraction to jam the frequency. (What is next -- Internet Marti?) Though she worries about disappointing her father, Miriam decides to emigrate to America. She writes her farewell letter using a complimentary pen from a Canadian company, with a red maple leaf on the cap. They have a final chat over a glass of Coca Cola. Then she boards the plane for a country that is not far away geographically, but a world away in terms of lifestyle. We last see her sometime later, noticably heavier, and she says she would not want to return. Meanwhile Ricardo and an old buddy reminisce and wonder why the revolution did not turn out the way it was supposed to.

    (13 October 99)

  • Toronto Thanksgiving
    This weekend I made a brief visit to Toronto. Canada was celebrating Thanksgiving, one month before the U.S., since winter arrives earlier in the Great White North.

    • I met up with my friend Ken, who is still alive after another summer of wild adventure. In the past few years he has developed (or maybe has always had) a liking for life-threatening recreation. If you are like me, you will be happy to just read about it on his website

    • Lives and Loves of Post-war Japanese Immigrant Women
      The main purpose of this visit was to attend a wedding. She is a shin-ijuusha (post-war Japanese immigrant). He is a second-generation Chinese Canadian. Like the descendants of turn-of-the-century Japanese immigrants, most shin-ijuusha women intermarry. Many subsequently divorce, creating social support challenges. This couple should be OK, though -- there have been no divorces among any of the people whose wedding I have attended! :-)

    • Lai Wah Heen 118 Chestnut Street, Toronto ON M5G 1R3 (416) 977-9899 ***
      In the Metropolitan Hotel near City Hall, this is a big, bright, airy room with a wall of floor-to-ceiling windows and modern decor offset by huge calligraphy hangings. Dim sum is a la carte here, not "off the cart" as it is at other restaurants. Some of the choices are slightly exotic -- emu dumplings (taste is similar to turkey). A popular place, so make reservations or come early.

    • Hockey Hall of Fame
      Strange that in five years of working in Toronto I never made it to the official museum of hockey. There are displays and activities numerous and varied enough to keep you occupied for hours if not days:

      • Great Moments Zone - A non-stop series of video clips of memorable goals and saves throughout hockey history. I couldn't watch for long without getting a lump in my throat, especially when the 1980s Edmonton Oilers were shown.
      • History of Hockey - Old jerseys, including one of the early 1900s Portland Rosebuds, as well as old equipment. I realized some of my own equipment could be on display!
      • Montreal Canadiens dressing room - a full-scale reproduction of the storied room in the old Forum de Montreal with the famous inscription, "To you with failing hands we pass the torch; be it yours to hold high."
      • Interactive zone - Be the shooter or the goalie in a virtual game.
      • Broadcast Zone - Record your own play-by-play of famous goals (I chose Gretzky's goal in 1981-82 that gave him 50 in 39 games); try your hand at reading a sportscast teleprompter.
      • Women's hockey - Recognition that the girls want to have fun as well. Brief profile of Vicky Sunohara of the Canadian women's national team
      • World of Hockey - Jerseys of teams from all over the world, in such unlikely places as South Africa, Australia, Greece and Israel. From the 1998 Nagano Olympics, the jerseys of Ryan Kuwabara, one of the Japanese Canadians who played for Japan on the men's team and Yuka Watanabe, goaltender for the Japanese women's team (it would have been more interesting to see her mask with all those purikura photo stickers stuck on it).
      • The Great Hall - A luxurious 1880s building that was the head office of the Bank of Montreal until 1949, now houses the NHL's hardware -- all of its individual and team trophies, including the holy grail, the Stanley Cup.
      Definitely worth a return visit!
    (09-11 October 99)

  • Turning Japanese: Memoirs of a Sansei
    Third-generation Japanese American David Mura's recollection of a year he spent in Japan is the first non-medical book I have finished reading in quite a while (a summer away from the computer helped). This book would have helped me grow more had I read it in 1991, when it was published. Instead, it was more affirming than anything else -- we share many similar experiences in North America and in Japan. He has a poet's way with words and expresses impressions and insights much more eloquently than I ever could.
    (09 October 99)

  • Face the Users: Human-Computer Interaction in Informatics
    One advantage of studying medical informatics at OHSU is the access students get to some of the leading lights in the field thanks to faculty contacts and the informatics industry around Portland. Today I had a rare Friday off work and so could attend this week's BICC Seminar/Conference, which was given by Dean F. Sittig, who recently started working for Portland-based WebMD. For the past couple of years now, Dr. Sittig has published the web journal The Informatics Review, a critical summary of current health informatics literature. His talk dealt with evaluation of user satisfaction with a health information system. Although he began by stressing the importance of the user interface for user satisfaction, by the end it became apparent that this was overshadowed by the hardware and networking issues of reliability and response time.

    On the topic of information systems, user interfaces and user satisfaction, you may have noticed that it is taking longer to get things done at the U.S. Post Office in recent weeks. A new workstation was introduced that requires that a specific code be entered with the sale of each different type of postage. Rather than having an icon-driven system with automatic coding, the worker has to go through the extra steps of looking up the code, then entering it. As information system implementations go, the U.S. Post Office has done many things we informatics students have been taught are no-nos:

    • Driven solely by management motives (inventory control)
    • No stake for the users, just extra work
    • Completely new user interface
    • Rudimentary, incomplete pre-implementation training (2 days)

    Often when an information system has this much going against it, the implementation is at risk for failure due to user frustration. We will have to see what happens ...
    (08 October 99)

  • Virtual Film Friends
    It used to be I would go alone to see films none of my friends wanted to see and have noone to discuss things with afterwards. The Movie Review Query Engine is a site that shows the breadth and power of the Internet and databases. A simple query retrieves many reviews from various sources on all but the most obscure films. It is like having seen the film with a busload of people!
    (07 October 99)

  • More server space management: I have moved my photo essay about Canada Sumo Basho 1998 to a new Internet address: pages.hotbot.com/sports/runker_room/sumo.html
    (05 October 99)

  • Mt. St. Helens Revisited [ LIVE VOLCANOCAM]
    On the way back to Portland from Seattle, I stopped in again at Mt. St. Helens National Volcanic Monument to see some of the the things I had missed on my visit last month.

    The Weyerhauser Forest Learning Center, just before the park boundary, teaches how the lumber giant was able to salvage some of the wood felled by the blast before drying, insects and fire reduced its value. A thick, hard layer of volcanic ash presented novel problems for chainsaws and tree planting. One display shows how sound waves reflecting between the ground and the atmosphere created a "deaf zone" that explains why the explosion was not heard in Portland OR but was audible in Eugene OR, further to the south. One video shows a year in the life of the elk that reside in the area.

    Another set of videos shows what is involved in modern tree cutting and sawmilling. I was impressed by how technology has been incorporated into almost every step, from genetics to select and/or create hardy, fast-growing strains, to computer-assisted design to map logging sites and plan logging roads, to robotics to cut the trees, to image analysis to optimize the number of planks from a given log's cross-sectional profile, to robotics to rotate the log in the appropriate orientation for the saw, to optical character recognition of the automatic sorter to read the writing of the people who grade the lumber, to bar code readers for inventory control. Lumber informatics must be a big field!

    This time I didn't bother with any of the intermediate stops, knowing that the most spectacular view was from the Johnston Ridge Observatory at the end of the road, less than 5 miles from the volcano. In the theatre, you can watch Message From The Mountain, an educational film. At the end of the show, the screen and the curtain behind it rise to reveal the volcano itself, through floor-to-ceiling windows that run the full length of the wall.

    I still need to go back to do some of the many hikes in the area, or maybe even some backcountry skiing.
    (03 October 99)

  • Seattle Restaurants
    I was in Seattle this weekend, and went to a couple of the local feeding spots:

    • Ivar's Salmon House 401 N.E. Northlake Way, Seattle WA 98105, (206) 632-0767
      Totem poles welcome you to this restaurant on the shore of Lake Washington, just under the I-5 bridge. This place is packed with masks, canoes and other artifacts of the Pacific Northwest First Nations people. Salmon is the specialty here (surprise!), and the portions are big. Nice cornbread accompanies every meal. There is a pier for those who want to sail up for dinner, and a takeaway window for those who can't get a table (reservations are strongly recommended).

    • Randy's Restaurant 10016 E. Marginal Way S. at Norfolk, Seattle WA (206) 763-9333
      This diner does not appear to have changed since the early 1970s, from its dark-stained wood with orange and pink leatherette decor (original) to the hairstyle of its friendly waitress (who possibly is also original). On the west side of Boeing Airfield, just south of the Museum of Flight, it maintains the aviation theme with numerous hanging scale models and framed pictures of planes. Even the mailbox is shaped like a Piper! Decent grub.

    A word of warning to those who would visit or even just pass through Seattle on fall weekends: be aware of the schedules of the University of Washington Huskies (college football), Seattle Seahawks (NFL football) and Seattle Mariners (major league baseball). Regardless of whether you are a sports fan, this vital information will help you avoid congestion areas on game day!
    (02-03 October 99)

  • Metric? SI!
    The Washington Post reported today that NASA lost its $125 million Mars Climate Orbiter last week because spacecraft engineers failed to convert English measurements to metric when exchanging vital data. The designers of the spacecraft used the English system (in, ft, lb), but the navigation team assumed they meant the metric system (cm, m, kg), so the commands they sent to the orbiter caused it to go missing.

    Why Americans continue to use the English system is beyond me. Given that they fought a war for their independence over 200 years ago, one would think they would be more than eager to rid themselves of any vestige of the shackles of Imperial rule. Still it persists, with consequences that range from expensive (like this incident) to humorous (like my gas jockey episode). In medical informatics, we use healthcare data interchange standards to help guard against similar errors when health care information is transferred.

    National Metric Week is 10-16 October 1999
    (01 October 99)

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