Use of Yokukansan (TJ-54) in the treatment of neurological disorders: a review.

Kampo herbal remedies are reported to have a wide range of indications and have attracted attention due to reports suggesting that these remedies are effective when used in disease treatment while maintaining a favourable quality of life. Yokukansan, also known as TJ-54, is composed of seven herbs; Angelica acutiloba, Atractylodes lancea, Bupleurum falcatum, Poria cocos, Glycyrrhiza uralensis, Cnidium officinale and Uncaria rhynchophylla. Yokukansan is used to treat insomnia and irritability as well as screaming attacks, sleep tremors and hypnic myoclonia, and neurological disorders which include dementia and Alzheimer's disease - the focus of this article. It is concluded that Yokukansan is a versatile herbal remedy with a variety of effects on various neurological states, without reported adverse effects. Traditional herbal medicines consist of a combination of constituents which account for the clinical effect seen. Likewise, the benefits of Yokukansan are probably attributable to the preparation as a whole, rather than to individual compounds.

Fracture epidemiology and control in a developmental center.

During 3.5 years, 182 fractures occurred among 994 residents of a developmental center. The fracture rate was 5.2 per 100 person-years (1.7 times greater than the rate in the US population). Fracture rate was significantly greater in residents with: epilepsy, older age, male gender, white race, independent ambulation, osteoporosis, and residence in intermediate care (versus skilled nursing) units; it was not affected by severity of mental retardation. Hand and foot bones were fractured in 58% of cases. Femur fracture occurred in 13 cases (7%). Fracture was caused by a fall in 41 cases (23%); its cause was indeterminable in 105 cases (58%). Fractures, occurring without significant injury, may be an important cause of preventable disability in this population. Control measures are suggested.

Parvovirus B19-antibody serosurvey in 500 developmentally disabled subjects.

Sera of 500 residents were screened for parvovirus B19 immunoglobulin M (IgM) and immunoglobulin G (IgG) by enzyme-linked immunosorbent assay. Positive IgM and equivocal IgG or IgM results were confirmed by immunofluorescent antibody and Western blot. IgM was detected in 13 sera (2.6%), and IgG was detected in 285 (57%). Records of IgM-positive residents contained no evidence of erythema infectiosum or polyarthropathy.

Lead exposure of people with developmental disabilities: success of control measures.

In a developmental center, blood lead level was determined by atomic absorption for individuals who were admitted, discharged, or had pica. In 1977, blood lead level was 0 to 29 ug/dL in 298 (92%), 30 to 49 ug/dL in 20 (6%), and 50 to 79 ug/dL in 5 (2%) of the 323 individuals screened. In contrast, in 1994, blood lead level was 0 to 4 ug/dL in 58 (88%) and 5 to 9 ug/dL in 8 (12%) of 66 individuals screened. The observed marked decline in blood lead levels in this population has been the result of effective pica management, several local lead abatement measures, and reduced environmental lead contamination. Medical Practice Guidelines are suggested for prevention of lead poisoning in developmental centers.

Occupational risk of hepatitis B from institutionalized mentally retarded HBsAg carriers: a prospective study.

In an institution for the mentally retarded, a total of 13 (2.4%) susceptible employees seroconverted for hepatitis B during 539 person-years. Two of them developed acute hepatitis B; the cost of their medical care and temporary disability was $7,772. Eleven seroconverters had no elevation of serum alanine aminotransferase, and all seroconverters recovered without chronic sequelae. Nine converters acquired antibody to HBsAg alone; three of these had no client contact. Difficulty in identifying nonoccupational causes of hepatitis B infection in the institutional setting often leads to labeling of all seroconversions as occupationally acquired. Hepatitis B vaccine is recommended for client-care personnel.

Epidemiology of hepatitis B infection in institutionalized mentally retarded clients.

In 1,149 clients of an institution for the mentally retarded, the prevalences of hepatitis B surface antigen (HBsAg) and hepatitis B virus markers were 12 per cent and 66 per cent, respectively. HBsAg prevalence was higher in males, Down syndrome, ambulatory, and older clients, and those with longer institutionalization. Serum alanine aminotransferase levels were abnormal in 31 per cent of HBsAg positive and 10 per cent of HBsAg-negative clients.

Occupational exposure to hepatitis B virus. Analysis of indications for hepatitis B vaccine.

This retrospective study was undertaken to determine the incidence of acute and chronic morbidity due to hepatitis B infection among employees of an institution for the mentally retarded. Based on a review of medical records, surveillance data, and serologic testing, we found no evidence of excess morbidity among 2,000 employees in a 10-year period. Hepatitis B vaccination is neither warranted nor presently cost-effective for most client-care personnel.