Safety of hospital vs home care of infant tracheotomies.
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Age Factors↗
Biomedical subjects
E Okamoto
Publications and source records attributed to E Okamoto.
Adverse effect of perioperative blood transfusions on survival after hepatic resection for hepatocellular carcinoma.
BACKGROUND/AIMS: Experimental and clinical studies have found a relationship between blood transfusion and altered immune function. We estimated the risk of transfusions for shorter survival on patients with hepatocellular carcinoma who underwent hepatic resection. METHODOLOGY: The impact of perioperative blood transfusions on 235 patients with hepatocellular carcinoma who had resections from January 1981 to December 1988 was retrospectively examined. All patients underwent hepatic resection and received no additional chemotherapy. RESULTS: Using the Cox proportional hazard model, the number of perioperative blood transfusions was found to be a significant prognostic factor for patient outcome (p = 0.03). Overall, patients who received less than 12 transfused units had a significantly better 5-year survival rate than those who received more than 13 transfused units (46.3% vs. 24.5%, p < 0.001). This result was also seen when the patients were subdivided by stage: 5-year survival in the early stage group (57.2% vs. 35.5%, p < 0.01) and in the advanced stage group (30.0% vs. 18.2%, p < 0.05). The number of perioperative blood transfusions also influenced the survival of patients who underwent a curative resection (66.2% vs. 38.5%, p < 0.01), but did not affect the survival of those who received a non-curative resection (7.9% vs. 7.4%). CONCLUSION: This study suggests that the number of perioperative blood transfusions is a significant prognostic factor in patients with hepatocellular carcinoma who undergo hepatic resection.
Carcinoma, Hepatocellular↗
Laparoscopic partial hepatectomy.
This article describes the surgical techniques and indications of laparoscopic partial hepatectomy, which is not as widely available as laparoscopic cholecystectomy. Three patients with hepatocellular carcinoma and associated severe liver cirrhosis were candidates for this technique from July 1993 to August 1994. The tumor size was 4 cm or less and all the tumors were located in segment 5 or 8 which had grown nodularly and protruded from the liver surface. A microwave tissue coagulator was used for parenchymal dissection under ultrasonographic guidance in a gas-less method with or without low-pressure pneumoperitoteum of 4 mmHg. The principle of dissection consists of tissue coagulation and fragmentation with dissecting forceps. Three hepatectomies were performed uneventfully without blood transfusion and the patients rapidly returned to their preoperative conditions. The laparoscopic partial hepatectomy can be an option of treatment in selected cases where the tumor can be removed by minor, superficial resection.
Carcinoma, Hepatocellular↗
[Survey of studies on the role of play in child nursing].
In this survey, 103 papers submitted to several nursing societies and published in leading nursing journals are outlined and analyzed in terms of motives for studies, kinds of play enjoyed by the subjects and effects of play on members of ward staff, child patients and their family members. The articles are listed in chronological order so that the changes and trends in the studies in this field will be shown. Studies on play started and developed in the clinical field for better ward management and more effective treatment. However, effects of play on development of child patients gradually became the focus of the studies. In terms of the subjects' level of health, it used to be limited to chronically-hospitalized patients who were not behaviorally limited. The scope of the subjects has widened to include "every health level". It's now purported that every patient regardless of his/her health level should enjoy the benefits of play. Regarding kinds of play, indoor plays were initially predominant, but subsequently outdoor activities became more popular with the playing repertoire increasing. Infantile stage has been and still is most frequently discussed in the field, while other developmental stages are now attracting more attention than before.
Child↗