Search PubMed⌕ Search

Biomedical subjects

M Washio

Publications and source records attributed to M Washio.

At least 55 records · Page 3Linked to original sources
PubMed1997

Reliability and validity of the Japanese version of the Zarit Caregiver Burden interview.

Despite a rapid increase in disabled elderly in Japan, the burden of the caregiver has not been properly assessed due to a lack of objective measurements. Our study was aimed at adapting and validating the Zarit Caregiver Burden Interview (ZBI) in Japan, which is one of the most widely used measurements for caregivers' burden in the United States. Sixty-six caregivers answered the self-administered questionnaire, involving the Japanese version of the ZBI and questions regarding their caregiving situation. Our study demonstrated that the Japanese version of the ZBI had equally as high reliability and validity as the original version. The Japanese ZBI had a high test-retest reliability (r = 0.76) and internal consistency (Cronbach's alpha = 0.93). The total score of the ZBI was highly correlated with the caregivers' score of the Center for Epidemiologic Studies Depression Scale (CES-D) score (r = 0.50), as well as a single global rating of burden (r = 0.71). It was also shown that demographic distribution of the score of the Japanese version had a similar trend to that of the original version. Caregivers who looked after patients with behavioral disturbances were found to have a significantly higher ZBI score than those who looked after patients without behavioral disturbances, which is consistent with previous findings. It is concluded that the Japanese version of the ZBI can be used to measure feelings of burden of caregivers in the Japanese population and can be used for cross-cultural comparison.

Activities of Daily Living↗
PubMed1997

The case fatality rate of methicillin-resistant Staphylococcus aureus (MRSA) infection among the elderly in a geriatric hospital and their risk factors.

From April 1991 to March 1993, there were 49 elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) infection in a geriatric hospital in Fukuoka, Japan. The retrospective study was carried out in order to evaluate the various factors which may influence the case fatality rate of MRSA infection among the elderly. Among them, 33 patients (67.3%) died while only 16 patients became culture-negative for MRSA and discharged after recovering from MRSA infection. A univariate analysis revealed that male sex (odds ratio [OR] = 12.25, 95% confidence interval [CI] = 2.80-53.55), hypoalbuminemia (OR = 3.83, 95% CI = 1.11-13.21) and an excessive usage of antibiotics (OR = 6.67, 95% CI = 1.70-26.09) were risk factors for death among the patients with MRSA infection. In a multivariate analysis, male sex and an excessive usage of antibiotics were still risk factors while hypoalbuminemia was not. However, hypoalbuminemina was more common in male patients than female patients (78.3% vs. 42.3%, p < 0.05). These findings suggest that the case fatality rate of MRSA infection may be high and also suggest that the elderly with MRSA infection who had hypoalbuminemia and/or received many antibiotics may have a poor prognosis.

Aged↗
PubMed1997

Methicillin-resistant Staphylococcus aureus (MRSA) isolation from pharyngeal swab cultures of Japanese elderly at admission to a geriatric hospital.

The isolation rate of the methicillin-resistant Staphylococcus aureus(MRSA) from pharyngeal swab cultures in Japanese elderly was studied at admission to a geriatric hospital. The subjects were 233 consecutive patients admitted to Kitakyushu Tsuyazaki Hospital from April 1994 to March 1996. The isolation rate of MRSA was 3.0% in the patients admitted from their own homes, 9.7% in those transferred from nursing homes and 14.0% in those transferred from other hospitals. The patients from their own homes were younger than those from nursing homes, the latter being older than those transferring from other hospitals. The patients from their own homes had better activities of daily living(ADL), higher levels of hemoglobin and serum albumin than those from nursing homes or other hospitals. The white blood cell counts, and the proportion of patients with positive c-reactive protein or with fever did not differ among the three groups. Multiple logistic regression analysis revealed that fever and ADL disability were independent risk factors for the isolation of MRSA, and hypoalbuminemia was a risk factor for MRSA isolation in the model using serum albumin instead of ADL score. These results suggest that the lower isolation rate MRSA among patients from their own homes may be partly due to better ADL and nutritional status compared with those from nursing homes or other hospitals.

Aged↗
PubMed1997

[Isolation of methicillin-resistant Staphylococcus aureus on admission to a geriatric hospital].

We studied the rate of isolation of methicillin-resistant Staphylococcus aureus (MRSA) from throat cultures obtained from elderly patients. The subjects were 151 consecutive patients admitted to Kitakyusyu Tsuyazaki Hospital from December 1994 to November 1995. MRSA was found more frequently in samples obtained from patients transferred from other hospitals or from nursing homes than in samples from those admitted from their own homes. Patients transferred from other hospitals or from nursing homes had lower levels of serum total protein, albumin, and hemoglobin, and also lower scores for activities of daily living than did those admitted from their own homes. Status prior to admission, nutrition, and the scores for activities of daily living may explain the differences in the rate of isolation of methicillin-resistant Staphylococcus aureus among patients admitted to geriatric hospitals.

Aged↗
PubMed1997

Risk factors for left ventricular hypertrophy in chronic hemodialysis patients.

Left ventricular hypertrophy is reported to be common in chronic hemodialysis patients, and also to increase the risk for mortality in chronic hemodialysis patients. An echocardiographical and clinical study was carried out to investigate the risk factors for left ventricular hypertrophy in 151 non-diabetic chronic hemodialysis patients without valvular diseases or myocardial infarction in two hemodialysis units in Fukuoka, Japan. The left ventricular mass index (LVMI) correlated positively to age, systolic blood pressure and interdialysis weight gain while it correlated negatively to the duration of hemodialysis therapy and hematocrit. Resorting to a multivariate analysis, the LVMI was found to positively correlate to age and the systolic blood pressure while it correlated negatively with the duration of hemodialysis therapy and the hematocrit level. These findings suggest that hypertension and anemia may thus be independent risk factors for left ventricular hypertrophy.

Cross-Sectional Studies↗
PubMed1997

The risk factors of death from the acetaminophen poisoning with antipyretic-analgesic drugs in Japan.

Since adverse effects rarely occur with the therapeutic doses of acetaminophen, it is commonly used as a mild antipyletic and analgesic. However, overdosage of acetaminophen causes fatal hepatic failure and acute renal failure. Therefore, we evaluated the risk factors for death among the reported cases of acetaminophen poisoning in Japan, which were obtained from Japan Science and Technology Corporation, Information Center for Science and Technology (JICST) on-line service in the Kyushu University Library. In a univariate analysis, the death rate of patients with hepatic failure (23.3% vs 0%, p = 0.04), disseminated intravascular coagulation syndrome (DIC) (38.1% vs 5.3%, p = 0.001) or plasma exchange treatment (33.3% vs 7.9%, p = 0.01) was significantly greater than those without it while a multivariate analysis revealed that DIC (with vs without; odds ratio = 23.04, 95% confidence interval = 2.80-189.75) and the treatment with plasma exchange (with vs without; odds ratio = 14.77, 95% confidence interval = 1.44-151.52) were independent risk factors. These results suggest that DIC and hepatic failure, especially requiring plasma exchange, were poor prognostic factors. In addition, about seventeen percent of the cases with less than 5 g of acetaminophen ingestion were death cases although the acute lethal adult dose is shown 13-25 g in western countries. This suggests that its acute lethal dose may be low in Japan, which may be partly due to the additional adverse effect of other drugs used in the mixed compounds while acetaminophen alone is used in western countries. An intensive treatment should be recommended for the acetaminophen poisoning patients regardless of the ingested dose.

Acetaminophen↗
PubMed1996

[Occupational dangers to health of nursing staffs in hemodialysis units].

Since hemodialysis patients are at high risk for blood-borne viral infection such as hepatitis B and C virus infection, nursing staffs of the hemodialysis units have a significant occupational exposure to blood-borne virus infection. Furthermore, they are in danger of contacting occupational low back-pain because they have to take care of patients in a half-rising position. In addition, they may also suffer from burned-out syndrome because they have to look after all the chronic renal failure patients as well as run machines during the hemodialysis procedure. In this paper, we describe occupational danger to health of nursing staffs working in hemodialysis units.

Back Pain↗
PubMed1996

Retrograde brain perfusion beyond the venous values. Hemodynamics and intracellular pH mapping.

Twenty-one dogs (group 1) had retrograde brain perfusion for 90 minutes through the sagittal sinus and superior vena cava with pressure-regulated cardiopulmonary bypass, and 10 dogs (group 2) had 60 minutes of circulatory arrest with an additional 30-minute evaluation of brain slices, both at 20 degrees C. In group 1, cerebral blood flow determined by laser flowmetry was 8.98 +/- 2.02 ml/100 gm/min with a driving pressure of 29.69 +/- 9.92 mm Hg during the retrograde perfusion, whereas it was 0.85 ml/100 gm/min during solitary perfusion through the superior vena cava. Retrograde cerebral vascular resistance was slightly higher than the antegrade resistance. Neutral red stain was given intraperitoneally as an intracellular pH indicator. Regional intracellular pH was calculated from photoabsorption at 440 and 535 nm with the use of color transparency photographs of the brain and spinal cord slices taken after retrograde cerebral perfusion in group 1 and after circulatory arrest in group 2. The pH mapping showed that the retrograde brain perfusion maintained the pH within 6.77 to 7.14, whereas the cerebral pH decreased to 6.24 to 6.43 at 60 minutes of circulatory arrest and further decreased to 5.81 to 6.22 at 90 minutes. The pH after the retrograde brain perfusion was significantly higher than the pH after circulatory arrest in the entire brain and the spinal cord. We conclude that the brain is protected when perfused retrogradely beyond the venous valves with a driving pressure above 20 mm Hg.

Animals↗
PubMed1996

Hypercholesterolemia and the progression of the renal dysfunction in chronic renal failure patients.

The effect of hyperlipidemia on the progression of chronic renal failure was investigated in 104 chronic renal failure patients, aged 39.3 +/- 2.9 years. The follow up period was 4.1 +/- 2.9 years. The serum creatinine level was 2.1 +/- 1.1 (mean +/- SD) mg/dl at the beginning of study and increased to 8.7 +/- 4.4 mg/dl at the end of the study. The reciprocal serum creatinine concentration (1/Cr) was plotted against the observation time, and the slope was calculated. The absolute value of the slope was used as the progression rate of renal impairment. The progression rate was positively related to total cholesterol level or urinary protein score, while it was negatively related to total protein level. Without the influence of urinary protein score, the progression rate correlated with total cholesterol level. The result suggests that hypercholesterolemia may be an independent aggravating factor in the progression of renal dysfunction in chronic renal failure patients.

Adolescent↗
PubMed1996

Incidence of methicillin-resistant Staphylococcus aureus (MRSA) isolation in a skilled nursing home: a third report on the risk factors for the occurrence of MRSA infection in the elderly.

A case control study was carried out in order to evaluate the various factors which may influence the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) infections in a skilled nursing home. From April 1991 to March 1994, bacterial cultures were performed in 55 out of 102 residents in a nursing home based on various clinical aspects. We divided 102 residents into following three groups; (1) the MRSA group (n = 10), residents whose materials for bacterial culture were positive for MRSA, (2) the non-MRSA group (n = 45), residents whose specimens were negative for MRSA but positive for other bacteria, (3) the control group (n = 47), residents who did not have to undergo a bacterial culture because they were free from moderate and severe infectious diseases. Compared with the control group, the activities of daily living score and the serum albumin level were significantly lower in the MRSA group and the non-MRSA group at the beginning of the study. In contrast, the number of antibiotics used prior to the bacterial culture and the proportion of hospitalization within 6 months prior to the bacterial culture were significantly larger in the MRSA group than in either the non-MRSA group, or the control group. These results thus suggest that a low activities of daily living score, the use of many kinds of antibiotics and a recent previous hospitalization may be risk factors of MRSA infection in a nursing home environment.

Aged↗
PubMed1996

[Surgical experiences of fenestrated total cavopulmonary connection in patients under four year of age].

The fenestrated Fontan operation is an interim steps for patients who considered to be at high risk for one step Fontan procedure. We performed total cavopulmonary connection with baffle fenestration in five patients under four year of age (33 month of mean age at operation). All patients previously underwent palliative surgery (Blalock shunt in 3, PA banding in 2). Three patients weighed less than 10 kg. Pulmonary vascular resistance index (PARI) were 2.03 +/- 0.18 U/BSA and exceeded 2 U/SQm in 3 patients. Nakata's indice were ranged from 282 to 644 (mean 394) mm2/BSA. Bidirectional cavopulmonary shunt was considered to be alternative pathway for three patients in staged Fontan strategy. Postoperative hemodynamics were relatively stable in all patients and weaned from mechanical ventilation within 5 days with various arterial oxygen saturation. There was no pleural effusion lasting longer than 1 week. One patient died of ileus caused from congenital malrotation. Follow up catheter examination at 1 year showed 83 to 96% of SaO2 and survived patients were doing well. Fenestrated TCPC can be applied safely in younger patients who are considered to need surgical treatments in staged Fontan strategy. Whether fenestration should be closed has to be wait further studies.

Age Factors↗
PubMed1995

In vitro evaluation of nicorandil, diltiazem, and prostaglandin E1 on hypothermic injury to immature myocytes.

The purpose of the present study was to evaluate the functional and biochemical effects of nicorandil (NRD), diltiazem (DTZ), or prostaglandin E1 (PGE) on cardiac myocytes incubated under hypothermic conditions. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days with MCDB 107 medium. Myocytes (12.5 x 10(5) myocytes/flask) were then incubated at 4 degrees C for 24 hr in media containing various concentrations of NRD, DTZ, or PGE. After hypothermic incubation, creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) were measured. The myocytes were then cultured for an additional 24 hr at 37 degrees C to evaluate the recovery of myocyte beating rate. In the nicorandil groups, 10(-4) M NRD showed significantly increased beating rate recovery compared to control (44.2% vs 24.6%, respectively, as a percentage of control, i.e., beating rate prior to hypothermic incubation). Treatment with 10(-6) M diltiazem showed no beneficial effects (10(-6) M: 25.2%; control: 29.8%); however, beating was not observed at 10(-4) or 10(-5) M. There were no significant changes among the PGE groups. The release of CPK and LDH was significantly suppressed with 10(-4) M NRD (10(-4) M: 24.1, 257.2 MIU/flask; control: 125.4, 459.5 mIU/flask, respectively). However, 10(-4) M DTZ showed significantly increased CPK and LDH levels compared to the control (10(-4) M: 203.3, 883.4 mIU/flask; control: 112.3, 457.4 mIU/flask, respectively). There were no significant differences for CPK and LDH levels among the PGE groups. In conclusion, nicorandil has protective characteristics for immature myocytes that may be suitable for cardiac preservation in the neonatal period.

Alprostadil↗
PubMed1995

Long-term hypothermic preservation of cardiac myocytes isolated from the neonatal rat ventricle: a comparison of various crystalloid solutions.

In this study, the functional and biochemical effects of crystalloid solutions on immature cardiac myocytes incubated under hypothermic conditions were evaluated. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days, following which 12.5 x 10(5) myocytes per flask were incubated at 4 degrees C for 3, 6, 12, and 18 h in five types of crystalloid solutions: lactated Ringer's (LR), St. Thomas' Hospital (ST), University of Wisconsin (UW), 5% glucose-based potassium (GK), and normal saline (NS). The levels of creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) in the solutions were measured after each hypothermic incubation, following which the myocytes were cultured for an additional 24 h at 37 degrees C to evaluate the recovery of the myocyte beating rate. In the LR, UW, and NS groups, the recovery ratios of the myocyte beating rate were over 95% of the control (the beating rate prior to hypothermic incubation) at 3 h, but decreased to 20.3, 15.1, and 0%, respectively, at 18 h. The ST and GK groups had significantly lower recovery ratios than the other three groups (72.9% and 63.4%, respectively) at 3 h. The release of CPK and LDH in the LR, UW, and NS groups was significantly suppressed compared to the ST and GK groups, with the greatest suppression observed in the LR group. Moreover, the ST and GK groups had the highest CPK and LDH levels, respectively. Thus, LR solution had the least cytotoxic effects, indicating that it could be the most suitable basic solution of the various cardioplegic or preservation solutions during the neonatal period.

Adenosine↗
PubMed1995

Poststreptococcal glomerulonephritis with the nephrotic range of proteinuria.

In order to characterize the clinical features in poststreptococcal glomerulonephritis (PSGN) in relation to the range of proteinuria, 27 patients with PSGN were divided into 3 groups according to the amount of urinary protein excretion; Group I: with proteinuria over 3.5 g/day (n = 8), Group II: with proteinuria between 1.0 and 3.4 g/day (n = 9) and Group III: with proteinuria less than 1.0 g/day (n = 10). Bed-rest was ordered until proteinuria decreased to less than 1.0 g/day. The serum creatinine levels in Group I were significantly higher than in Group III both on admission and at discharge, although the duration of hospitalization was longer in the former than in the latter group. Furthermore, the durations of proteinuria and hypocomplementaemia were longer in the former than in the latter. In addition, the former showed a higher systolic blood pressure and a greater expanded extracellular fluid volume expressed as body weight change during hospitalization. However, none of the patients in this study demonstrated any persistent proteinuria or renal function impairment. In conclusion, bed-rest in the acute phase of PSGN might improve the short-term prognosis of PSGN.

Adult↗
PubMed1995

Hypoxic injury of immature cardiac myocytes under various hypothermic conditions using an in vitro cell-culture model.

The purpose of this study was to evaluate the functional and biochemical effects in immature cardiac myocytes under hypoxic and hypothermic conditions. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days, after which 12.5 x 10(5) myocytes/flask were incubated under 3% hypoxic conditions at 4 degrees C, 10 degrees C, 15 degrees C, 20 degrees C, 25 degrees C, and 37 degrees C for 6, 12, and 24 h. After each hypoxic incubation, creatine kinase (CK) and lactate dehydrogenase (LDH) were measured in the incubation medium. The myocytes were then cultured for an additional 24 h at 37 degrees C to evaluate the recovery of the myocyte beating rate. In the 4 degrees C and 37 degrees C groups, the myocyte beating rate recovery markedly decreased with increasing incubation times from 78.1% and 97.2% at 6 h to 0.0% and 38.4% of the control, which was the beating rate prior to hypoxic incubation, at 24 h, respectively. However, in the 10 degrees C, 15 degrees C, and 25 degrees C groups, this value decreased significantly only at 24 h. In the 20 degrees C group, beating rate completely recovered in 24 h. A marked increase was found in the release of CK and LDH in the 4 degrees C group from 28.5 mIU/flask and 232.9 mIU/flask at 6 h to 83.7 mIU/flask and 640.7 mIU/flask at 24 h, respectively. However, in the 25 degrees C and 37 degrees C groups, this release was significantly increased only at 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

[Valve repair or valvulectomy without replacement for infective endocarditis: a report of 11 cases].

Recently advances in early diagnosis of infective endocarditis (IE) by echocardiography provide for IE as a target disorder for valve repair. Valvulectomy without replacement might be still better operation of choice for some cases of intractable right-sided endocarditis. For our experience in 11 cases of valve repair or valvulectomy without replacement for IE, actuarial survival and reoperation-free rate at 6.8 years of mean follow-up after surgery was 81.8% and 90.9%. Persistent infection and intraoperative evaluation of the residual regurgitation was the point for postoperative management after these procedures. Although an elaborative valve repair should be applied for right-sided endocarditis, total pulmonary valvulectomy or regional tricuspid valvulectomy without prosthesis was available for destructive endocarditis.

Adolescent↗