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Biomedical subjects

H Asano

Publications and source records attributed to H Asano.

At least 163 records · Page 9Linked to original sources
PubMed1987

Factors affecting general job satisfaction of caregivers in nursing homes.

The important factors affecting general job satisfaction of caregivers in nursing homes in Tokyo were analyzed. The general job satisfaction of caregivers proved to be strongly correlated with such factors as frequency of night shifts, relationship with supervisors and length of employment, feeling of self-esteem and motive for taking the present job, satisfaction with work itself and tension and/or frustration experienced in working with the aged, and education. Such factors as cognition of the necessity of the aged services and knowledge of ageing and old people did not have any great impact on general job satisfaction of caregivers. These findings suggest the necessity of improving work conditions and human relations in workplace, the importance of attitudes and feelings of caregivers when hiring them, and the necessity of the adequate cognition and knowledge in working with the aged in nursing homes.

Adult↗
PubMed1987

Immediate and early postoperative evaluation of results of cardiac surgery by transesophageal two-dimensional Doppler echocardiography.

In cardiac surgery significant residual lesions increase postoperative morbidity and mortality. Although intraoperative epicardial real-time two-dimensional Doppler echocardiography (two-dimensional Doppler) is an accurate and efficient technique for assessing the presence and severity of a residual lesion, it requires placement of a transducer in the operating field and consequent obstruction of the operative procedure. Transesophageal two-dimensional Doppler echocardiography (transesophageal two-dimensional Doppler), which can be applied intraoperatively and postoperatively without such problems, was performed in 35 patients during cardiac surgery (12 patients) and/or at an intensive care unit within 6 hr after cardiac surgery (30 patients). In those with constrictive pericarditis, an extensive pericardiectomy was performed with effective monitoring by intraoperative transesophageal two-dimensional Doppler. Abnormal posterior wall motion was observed in the case of left ventricular rupture (type III) after mitral valve replacement 3 hr before clinical manifestation. After prosthetic valve replacement (18 St. Jude Medical valves, one Carpentier-Edwards valve, one Björk-Shiley valve), no perivalvular leakage was detected, but minor physiologic transvalvular leakage was noticed in 11 patients with St. Jude Medical valves. In two patients with congenital heart disease, a small residual shunt was detected. In a patient in which a composite valve graft with direct coronary artery reattachment (Bentall's operation) was performed, reattachment was confirmed to be satisfactory. In conclusion, intraoperative and early postoperative monitoring of cardiac function by transesophageal two-dimensional Doppler echocardiography can improve the results of cardiovascular surgery by providing accurate information on cardiovascular structure and blood flow dynamics.

Adult↗
PubMed1986

Doppler ultrasound examination of prosthetic function and ventricular blood flow after mitral valve replacement.

Two-dimensional color Doppler echocardiography enables delineation of the spatial and temporal distribution of blood flow in the heart. In this study, the method was applied for investigation of flow dynamics in multiple planes in the region of prosthetic mitral valves for comparison with that of native mitral valves. In 15 healthy subjects there was normal flow toward the transducer, coded in red, in the left ventricle along the posterolateral wall (left ventricular inflow region) and blue-coded flow away from the transducer in the left ventricular outflow region during diastole. In 40 patients with St. Jude mitral valve prosthesis and 17 with bioprosthesis the flow pattern in the left ventricle was reversed. Mitral inflow was directed against the interventricular septum, accordingly, into the left ventricular outflow region while the outflow pattern was displaced posterolaterally into the left ventricular inflow region during diastole. The angle between the aortic valve ring and the mitral annulus was significantly smaller than in the healthy subjects. The angle between the central axis of the mitral prosthesis and the mitral inflow, which was 0 degrees in healthy subjects, was increased by the medial deviation in particular, in those with mechanical St. Jude prostheses. The maximal transprosthetic velocity, measured in 70 patients, and the maximal pressure gradient calculated according to the Bernoulli equation was substantially greater than the values in healthy subjects. In contrast to findings associated with normally-functioning prostheses, in four patients with prosthetic malfunction there was a diastolic peak velocity of more than 2 m/s as well as marked turbulence in the inflow region.

Bioprosthesis↗
PubMed1986

[A clinical evaluation of MK-0787/MK-0791 for long-term administration in urological infections].

MK-0787 (Imipenem)/MK-0791 (Cilastatin sodium), a new compound of Thienamycin, was administered in treatment of 35 patients (36 cases) with chronic complicated UTI or for prevention of serious infections with much complicated factors. The patients were principally treated at a daily dose of 1 g for over 10 days. The efficacy rate of 26 patients who were evaluable in the early phase (4-7 days) was 88.5%, while it became up to 92.3% in the final phase judgment. As for clinical usefulness, the result was obtained to be as high as that of the clinical efficacy. In bacteriological study, 35 strains were clinically isolated including 7 strains of P. aeruginosa from UTI. All the strains disappeared with an eradication rate of 100% after treatment. Strains appearing after Imipenem/Cilastatin sodium treatment mainly consisted of fungi. Usefulness judgements tended to be greater in the final phase than in the early phase. As for side effects, vomiting was recorded in one case, in which the administration was discontinued. In laboratory findings there were 3 cases with elevated GPT, 2 cases with elevated GOT, one case with elevated gamma-GTP, one with thrombocytopenia, and one with eosinophilia each, but these abnormal values were slight and transient. In summary our clinical study showed that Imipenem/Cilastatin sodium was a very effective antibiotic in treatment on moderate or serious UTI or preventive use for infections in compromised hosts. Considering the features of this agent, it might be more effective and useful for clinical use in treatment on polymicrobial infections including stubborn organisms than any other antimicrobial compounds. Furthermore, it was safe and well tolerable in a long term treatment.

Adult↗
PubMed1986

Higher susceptibility of mast-cell-deficient W/WV mutant mice to brain thromboembolism and mortality caused by intravenous injection of India ink.

(WB X C57BL/6)F1-W/WV mice possess a genetic defect in multipotential hematopoietic stem cells; the mice are anemic and lack mast cells. The authors injected diluted India ink intravenously into W/WV mice and congenic normal +/+ mice and searched for genetically determined differences in the development of complications of the injection. In both W/WV and +/+ mice, intravenous ink resulted in thrombocytopenia and markedly prolonged bleeding times, as well as prolonged partial thromboplastin and prothrombin times and reduced fibrinogen concentrations. These effects were similar in W/WV and +/+ mice, although the reduction in platelet counts was greater in W/WV mice. In addition, the mortality associated with ink injection was significantly higher in W/WV mice than in congenic +/+ mice. Most W/WV mice which died first exhibited paralysis, and examination under the dissection microscope revealed that ink injection resulted in significantly more cerebral thromboemboli in W/WV mice than in +/+ controls. Bone marrow transplantation from +/+ mice corrected both the mast cell deficiency and the anemia of W/WV mice and protected the W/WV recipients from the adverse consequences of ink injection. By contrast, +/+ mice rendered as anemic as W/WV mice by breeding did not exhibit increased morbidity and mortality after ink injection. (WC X C57BL/6)F1-Sl/Sld mice, which are anemic and lack mast cells because of a genetic defect different from that of W/WV mice, also exhibited increased morbidity and mortality after intravenous ink. Finally, mixture of ink with commercial heparin prior to intravenous injection markedly reduced the incidence of cerebral thromboembolism and death in W/WV mice. Taken together, these findings suggest that the increased morbidity and mortality exhibited by W/WV and Sl/Sld mice that received injected ink might be related to their mast cell deficiency rather than to their anemia. But measurement of the histamine content of the blood and various tissues of WBB6F1-+/+ mice injected with ink, and examination of their tissues in 1-mu sections, indicated that intravenous ink did not cause substantial mast cell degranulation. As a result, the possibility that mast cells protect +/+ mice from the adverse effects of intravenous ink by a mechanism other than degranulation and release of heparin, or that the differences in the response of W/WV or Sl/Sld mice and their +/+ littermates are due to defects other than their lack of mast cells, cannot be excluded.

Animals↗
PubMed1985

Cyclosporin A effective therapy for fifty-two cadaver kidney recipients.

Fifty-two consecutive patients receiving cadaveric renal transplants were prescribed cyclosporin A and steroid therapy. Three of the recipients underwent re-transplantation and two of the patients were grafted with kidneys shipped from the United States. One year actuarial patient and graft survival rate with no exclusions were 94.2 percent and 81.6 percent, respectively, this rate being significantly better than results in case of the conventional combination of azathioprine, steroid and antilymphocyte globulin. The role of HLA-DR matching on cyclosporin A treatment was studied. One year actuarial graft survival rates of two HLA-DR matched and one HLA-DR matched were 91.7 percent and 78.9 percent, respectively. To assess the effects of cyclosporin A in the management of patients with acute tubular necrosis, the patients were divided into two groups, in terms of whether or not hemodialysis treatment was required for acute tubular necrosis. Although in the present protocol, cyclosporin A administration was begun before the operation, no significant differences in the graft survivals were evident between the two groups. Nephrotoxicity, hepatotoxicity and other side-effects of cyclosporin A could usually be dealt with by dosage adjustments, making feasible the chronic ingestion of this agent. The exceptional effectiveness and safety of cyclosporin A were evident throughout these early trials.

Adolescent↗