Biomedical subjects

S Murashima

Publications and source records attributed to S Murashima.

At least 55 records · Page 3Linked to original sources

PubMed1996

[Presurgical evaluation of cerebral perfusion reserve in patients for cardiovascular surgery using 99mTc-ECD SPECT with diamox enhancement].

Cerebrovascular stroke is one of the major complications in cardiovascular surgery with cardiopulmonary bypass. The purpose of this study was to evaluate the usefulness of preoperative 99mTc-ethyl cysteinate dimer (ECD) SPECT and acetazolamide (diamox) enhancement to predict neurological complications in cardiovascular surgery. Eighteen patients with coronary disease, valvular disease or aortic aneurysm were studied before the operations. Regional cerebral blood flow and perfusion reserve were evaluated using ECD SPECT before and after the intravenous administration of diamox (1 g). Three cases with moderate to severe baseline abnormalities and poor perfusion reserve had cerebral infarction postoperatively. Twelve cases with good to fair perfusion reserve had no neurological complication. Three cases having poor perfusion reserve had the operations with more intensive brain protection, in which higher perfusion pressure to the brain was maintained during cardiopulmonary bypass, and no neurological complication was observed. In conclusion, patients who have moderately or markedly abnormal baseline flow with poor perfusion reserve may have some risk of neurological complications in cardiovascular surgery. ECD SPECT with diamox enhancement may give information useful for selection of operation procedures.

Acetazolamide↗

PubMed1995

[Changes in nurses' knowledge and attitudes regarding AIDS in Mie Prefecture, Japan].

In 1990, we conducted a questionnaire survey showing that many nurses had incorrect knowledge of AIDS resulting in inappropriate attitudes toward AIDS patients. Following the first survey conducted in 1990, nurses were given various forms of AIDS education. The effectiveness of the AIDS education requires assessment. Therefore a second questionnaire survey was performed in 1993 to assess changes in nurses' knowledge and attitudes regarding AIDS. The same questionnaire as used in the first survey was sent to a random sample of nurses working at general hospitals in Mie Prefecture, Japan. The questionnaire covered knowledge of AIDS, psychological responses, attitudes and conduct around infected persons and measures against AIDS. Results of both questionnaire surveys showed that the majority of nurses acquired their knowledge predominantly from the mass media, and a large number of nurses worried that AIDS would spread in Japan. Almost half of the nurses were worried that they might be infected with AIDS. The second survey showed that nurses who acquired knowledge of AIDS from printed material, pamphlets and other educational resources, including lectures had increased. In 1993, many more nurses had accurate knowledge compared to the number in the first survey. In 1993 the number of nurses who discriminated against AIDS patients and HIV-infected persons had decreased.

Acquired Immunodeficiency Syndrome↗

PubMed1995

[A study on health and caregiving status of the elderly over age 75 living in urban Tokyo--social services and caregiving for the bedridden and senile elderly].

Interviews during home visits were used to assess social services and caregiving status for the bedridden and senile elderly living at home in urban Tokyo. In Chuo ward 197 bedridden and senile elderly were identified from 3,409 mailed surveys (response rate 5.8%). This study analyses data from 110 subjects who were followed up with interviews during home visits. As indicated by the Karasawa senile scale, 70% of the respondents have communication problems with the elderly person in their care. Incontinence problems are reported in 56.7% of the frail elderly. There is no significant association between incontinence problems and decisions by caregivers to institutionalize the elderly. The mean age of the main caregiver is 61.9 +/- 12.7 years. There are 55.5% of the families with secondary caregivers. The mean period of care is 6.3 +/- 8.2 years. Even the families who take care of their elderly relative for longer periods of time have no one to consult about caregiving. Caregiver strain was measured by the Family Maslach Burnout Inventory. The subscale, emotional exhaustion, occurs most frequently. Only 25.0% of caregivers indicate willingness to accept social services, on the other hand 63.5% of the caregivers desire family care. The questionnaire listed twenty five resources currently available for families in this ward for social services. Only 52.2% know about resources for social services. Only 8.5% of the respondents use social services. Respondents know about and use social services for direct care of their elderly relative more than they use support for adapting the home environment for the care of the elderly. These findings suggest the following: (1) In order to promote effective use of social services a systematic case finding and assessment plan is needed. (2) Development of services from the viewpoint of prevention and emotional support are needed. (3) Case management is needed to achieve a mix of both the family care and social services.

Aged↗

PubMed1995

[The content and its teaching method of nursing for the elderly in baccalaureate program].

PURPOSE: The study is intended to examine the content of gerontological nursing for the baccalaureate program in nursing and to review its teaching methods. METHODS: Articles and books were reviewed extensively, information was gathered from various gerontological health professionals and family caregivers were interviewed, and a survey was conducted by questionnaire on the students' views of the elderly people. RESULTS: The contents of gerontological nursing education included features of the elderly, trends of social situations for the elderly and characteristics of the gerontological nursing approach. Features of the elderly mean a comprehensive understanding of the elderly including physical, psychological and social aspects. Characteristics of gerontological nursing included assistance for the elderly, assistance for families, and intervention for the organization which supports the elderly. In providing assistance to the elderly, it is necessary to be sensitive and to respect their life, independence, dignity, and relation with society. The teaching method of gerontological nursing education should be organized according to the principles of learning, that is, from familiar subjects to unknown subjects, and from simple to complicated ones. For future study, a detailed examination of the contents and methods of gerontological nursing education is needed.

Curriculum↗

PubMed1994

Fallopian tube disease: limited value of treatment with fallopian tube catheterization.

PURPOSE: Therapeutic role of fallopian tube catheterization was prospectively studied in patients with bilateral fallopian tube obstruction. MATERIALS AND METHODS: Catheterization was performed in 42 patients with bilateral obstruction; 36 of the patients (67 fallopian tubes) underwent recanalization. RESULTS: Fifty-two tubes with 54 proximal obstructions were successfully recanalized (technical success rate, 96%), 36 with selective catheterization and 16 with coaxial techniques. Among 13 tubes blocked at the distal portion of the tube, six tubes were negotiated. Perforation or subintimal injury occurred in three tubes, and one patient eventually had a tubal pregnancy. During follow-up of 3 months to 4 years, five patients had conceived, including the patient with a tubal pregnancy and one patient who experienced spontaneous abortion during the first trimester. CONCLUSION: Fallopian tube catheterization is technically highly successful and diagnostically useful. However, its role in treating fallopian tube diseases is limited, and patients with distally blocked tubes are not good candidates for this procedure.

Adult↗

PubMed1994

CT-guided biopsy of the chest: usefulness of fine-needle core biopsy combined with frozen-section pathologic diagnosis.

PURPOSE: To improve the diagnostic accuracy of computed tomography (CT)-guided biopsy of the chest. MATERIALS AND METHODS: The usefulness of fine-needle core biopsy combined with immediate frozen-section diagnosis by pathologists was prospectively studied. Fifty-five biopsies of the chest were performed under CT guidance in 55 patients with 36 malignant and 19 benign processes. Initial biopsy was always attempted with a 21-gauge modified Menghini needle; tissue samples were sent to the pathology department immediately after biopsy for pathologic diagnosis of the frozen sections. RESULTS: In 47 of 55 lesions (85%) sufficient materials for diagnosis were obtained and enabled correct final diagnosis. Specific histologic diagnosis was possible in 25 (74%) of 34 malignant and 10 (77%) of 13 benign lesions. In all of the eight other lesions, cytologic diagnosis of aspirated material was correct. No false-positive or false-negative results have occurred. CONCLUSION: Histologic diagnosis with frozen sections improves diagnostic accuracy of chest biopsy; immediate pathologic diagnosis is an encouraged adjunct.

Adolescent↗

PubMed1994

Long-term survival in a patient with malignant carcinoid treated with high-dose octreotide.

Octreotide acetate, a long-acting somatostatin analogue, is effective in controlling and markedly reducing the symptoms of carcinoid crisis. We report a patient with carcinoid syndrome with prolonged survival for 4.5 years with high dose octreotide therapy and survived for 7.5 years after the first flushing, in spite of episodes of severe carcinoid crisis. Dose escalation was required in order to control carcinoid symptoms, and the final dosage was 5,950 micrograms/day. Although administration of such a high dosage of octreotide has never been reported before, we found that octreotide could be used at this dosage safely without inducing serious side effects, and probably prolonged the patient's survival. Our experience with this case indicates that octreotide acetate is an effective drug in controlling carcinoid crisis and prolonging survival without serious side effects.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1994

[Health behavior model based analysis of factors affecting alcohol behavior of company employees].

Factors affecting alcohol behavior were studied using, as a conceptual framework, a Health Behavior Model on Alcohol (Alcohol Behavior Model), adapted from Munakata's Health Behavior Model. Under this model alcohol behavior is restricted or promoted by the levels of self-initiative ability, which influences both health promotion factors and health hindrance factors. How these factors influence alcoholic behavior in company employees was studied. Employees were asked to complete questionnaires when they came to health centers for their regular health examination between August to September 1990. Two hundred and ninety-two of the three hundred subjects answered the questionnaire. Results indicate that the major factor for restricting alcoholic behavior was self-efficacy regarding drinking alcohol. The self-efficacy level was increased by the persons' perceived vulnerability to alcohol and was decreased when alcohol functioned as an aid to recover from fatigue or to lower stress. As a conclusion, empowering clients to enhance self-efficacy appears to be effective as a health objective for coping with alcoholic behavior.

Adult↗

PubMed1993

Spa bathing activates fibrinolysis in patients with cerebral infarction.

The effects of spa bathing on blood coagulation and fibrinolysis were studied in 20 patients with chronic cerebral infarction. Blood was obtained before and after a 10-minute period of spa bathing at 41 degrees C. Prothrombin time, activated partial thromboplastin time, fibrinogen, factor VIII activity, von Willebrand factor activity, and antithrombin III activity did not show significant changes after bathing, but euglobulin lysis time was significantly reduced (p < 0.01) and fibrin lysis activity was increased (p < 0.05). These findings suggest that spa bathing activates fibrinolysis without markedly changing blood coagulation in patients with chronic cerebral infarction. It is thought that the activation of fibrinolysis without the activation of coagulation has a favorable effect on blood circulation. The results of fibrin-plate assays using C1 inactivator indicated that tissue-type plasminogen activator was the major contributor to the activation of fibrinolysis during spa bathing.

Aged↗

PubMed1993

[AIDS-related knowledge among nurses in Mie Prefecture, Japan].

Levels of understanding and knowledge regarding AIDS were investigated for medical personnel working at general hospitals with more than 100 beds in Mie Prefecture by means of a questionnaire during May to June, 1990. The questionnaire covered general knowledge of AIDS, psychological response, attitudes and actions taken toward infected persons, and societal countermeasures against AIDS. Responses from 1,516 nurses and assistant nurses were statistically investigated among medicare persons. Mass media was the major source of knowledge on AIDS for the nurses and assistant nurses. Level of understanding on AIDS, however, appeared to be rather low, which may be due to difficulty in obtaining accurate information on AIDS and also due to lack of motivation to study. The responses of nurses were more positive than for assistant nurses for action taken in hypothetical cases of infection to themselves, spouses or familiar persons. Similar differences were also shown in responses regarding societal countermeasures against the disease.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Chromaticity analysis of immunostained tumor specimens.

In order to evaluate the correlation between immunohistochemical and morphometric data on the same histological sections, we have developed a flexible color image analyzer (Microcomputer-Assisted Picture Processing System type II, MAPPS-II), and established an effective method to analyze the immunostained colorectal neoplasms based on the color recognition theory of human visual system. Colorectal adenomas and adenocarcinomas were stained with a monoclonal antibody C 12, which recognizes abnormal H antigen, using Avidin-Biotin method and diaminobenzidine (DAB, brown dye). Nuclei were stained with Hematoxylin (blue dye). Density and colorimetric analyses revealed two results: (A) Separation of immunostained brown area from blue nuclei was best performed by plotting the representative sample areas on a standard chromaticity diagram, which displays the hue and saturation of colors simulating color of human visual system. (B) After separation of immunostained areas, usual density analysis was useful for the assay of nuclear morphometric information. Using these programs, normal mucosa was negative for C 12, and showed low nuclear/cytoplasmic ratio (NCR). Adenoma was occasionally focally positive for C 12, and showed medium NCR. Carcinomas were C 12 positive, and showed high NCR. Our method permits nuclear counterstaining by hematoxylin instead of low contrast methyl green, which will widen the field of combined immunohistochemical and morphometric study.

Adenocarcinoma↗

PubMed1992

Late-onset homozygous protein C deficiency manifesting cerebral infarction as the first symptom at age 27.

We report a 31-year-old female who had repeated thrombosis and was diagnosed as having congenital homozygous protein C deficiency based on decreased protein C antigen and activity, and the findings of family history. This patient had shown no symptom of thrombosis until the age of 27 years, when she had cerebral infarction as the first symptom. Low molecular weight heparin was useful for disseminated intravascular coagulation (DIC) that complicated protein C deficiency in this patient.

Adult↗

PubMed1992

[Study on the relationship between toddler temperament and development (second report)--the relationship between toddler temperament and developmental delay].

The purpose of this study is to clarify the relationship between toddler temperament and developmental delay, and to examine whether the result could be adapted to the health practice of mother and child. As the conceptual framework, we used A. J. Sameroff's transactional model. Questionnaires concerning toddler temperament, rearing environment and toddler development were sent to mothers whose children were scheduled to receive 1 year and 6 months child health examinations, and collected 306 responses. We assessed the developmental status of 41 children among the 306 by means of the Japanese edition of the Denver Developmental Screening Test. All 306 children were classified into either the developmental delayed group (30) or the normal group (275). The data analyses were conducted both quantitatively and qualitatively with the following results. Compared with normal children, developmentally delayed children showed these characteristics: (1) The temperamental category scores of adaptability and persistence were higher, indicating low adaptability and persistence. The prevalence of difficult child, slow to warm up (STWU) child and intermediate high child was relatively higher, with STWU child the highest. (2) The score for the rearing environment was lower. (3) There were cases where disagreement between a child's temperament and the mother's rearing behavior had an influence on the child's development. As a conclusion, these results indicate that a child's temperament must be considered developmental and child-rearing counseling in child health examinations.

Child, Preschool↗

PubMed1992

[Study on the relationship between toddler temperament and development (first report)--the correlation among toddler temperament, maternal perception and rearing environment].

The purpose of this study is to clarify how a child's temperament and maternal perception influences the rearing environment. As the conceptual framework, we used A.J. Sameroff's transactional model and Miyake's conceptual model of mother and child. The following process was hypothesized: toddler temperament influences maternal perception, which in turn influences rearing environment under which children are developing. Questionnaires concerning toddler temperament, maternal perception and rearing environment were sent to mothers whose children were scheduled to receive 1 year and 6 months child health examinations, and results from 306 mothers and children who answered the questionnaires were analyzed. The results were as follows: (1) Child temperament showed a tendency to accord with maternal perception of how easy it is to handle him/her. (2) Maternal perception was related to rearing environment. (3) Temperamental characteristics were related to rearing environment. (4) While the influence of child temperament and maternal perception on the rearing environment was not shown to be strong, the hypothesized process of this study was supported to a certain degree. From these results, it appears that it is important to pay attention to a child's temperament as a contributing factor in the health practice of mother and child.

Child Rearing↗

PubMed1992

[Study on fibrinolysis and platelet function].

The aim of this study is to evaluate the relationship between tissue plasminogen activator (tPA)/PA inhibitor (PAI) complex and PAI, and platelet in the circulating blood. tPA/PAI complex and active PAI (act PAI; Teijin Co., Japan), and PAI antigen (PAI ant; Biopool AB, Sweden) were assayed by enzyme immunoassay (EIA). The mean concentrations (ng/10(9) platelets) in supernatant from lysate of platelet rich plasma (PRP) and washed platelets were 27.1 +/- 9.2, 1.5 +/- 1.2 in tPA/PAI complex, 188.7 +/- 46.1, 83.3 +/- 7.5 in act PAI and 236.2 +/- 41.6, 191.9 +/- 45.1 in PAI ant, respectively. PRP was mixed with ADP (10(-5), 10(-4), 10(-3) M), for 3 min and the supernatant after centrifugation then was provided for assay of PAI and tPA/PAI complex. Concentrations of act PAI, PAI ant and tPA/PAI complex dose-dependently increased with ADP. Almost the same results were obtained, when collagen and other agents were used instead of ADP. This study revealed that platelets contained quantities PAI (as free PAI) and released PAI during aggregation, and that a part of the PAI immediately formed a complex with tPA. Those findings suggested that platelets may play an important role on the formation of thrombus, in the way of anti-fibrinolysis, in addition to novel platelet functions, such as aggregation.

Adult↗

PubMed1991

Dynamic fluctuations in blood of thrombin/antithrombin III complex (TAT).

The dynamic fluctuation of thrombin-antithrombin III complex (TAT) was studied in blood obtained during the daytime (at 9 AM, noon, 3 PM), during extracorporeal circulation and during the course of disseminated intravascular coagulation (DIC), to certify whether the level of TAT in blood can reflect the generation of thrombin. In 10 healthy male volunteers, the mean values of TAT (micrograms/liter) were 1.74 (+/- 1.36) at 9 AM, 1.22 (+/- 0.47) at noon, and 1.25 (+/- 0.68) at 3 PM. TAT did not show a daytime fluctuation, unlike fibrinolytic factors. The mean values of TAT in 38 hemodialyzed patients were 4.83 (+/- 2.8) before the initiation, 6.59 (+/- 4.39) in the first hour, and 13.42 (+/- 10.96) at the end of a dialysis session. In 20 patients undergoing open heart surgery, the mean value of TAT was increased during cardiopulmonary bypass (CPB) and decreased with time after the end of surgery. The fibrinopeptide A (FPA) value was increased with TAT during CPB but achieved a maximum level immediately after heparin neutralization by protamine. In 20 patients with DIC, the values of TAT varied from 5.8 to 297 micrograms/liter in the blood at the onset of DIC. In seven of eight patients treated with low-molecular-weight heparin (LMW-H), the values of TAT and FPA were lower 24 hr after LMW-H than before the treatment. These results suggest that the level of TAT in blood reflected the formation of thrombin and could serve as a sensitive parameter of activated coagulation in circulating blood.

Adult↗

PubMed1991

[Plasma thrombomodulin levels in elderly subjects].

Plasma levels of thrombomodulin (TM), fibrinogen, antithrombin III (ATIII) and thrombin ATIII complex (TAT) were studied in healthy young subjects (group A), healthy elderly subjects (group B) and patients with level of TM in group B tended to be higher than that in group A. Levels of TM, fibrinogen and TAT in group C suggested the presence of a hypercoagulable state. When group C was further divided into those with and without diabetes mellitus (DM), the TM level in the former tended to be higher than that in the latter. Furthermore, among the patients with DM, those with diabetic retinopathy showed significantly higher levels of TM than those without retinopathy. Thus, high TM levels indicate the presence of endothelial injury. In groups B and C, TM correlated positively with fibrinogen, and negatively with ATIII, which also indicates that a high TM level is related to a hypercoagulable state. In conclusion, the TM level is considered to be a potential marker of the presence of endothelial injury.

Adult↗

PubMed1991

Comparison of putative cGMP-binding regions in bovine brain and cardiac cGMP-stimulated phosphodiesterases.

After photolabelling of purified bovine brain particulate cGMP stimulated phosphodiesterase (PDE) with [32P]cGMP, incubation with V8 Endoproteinase Glu-C produced several fragments; most of the [32P] was associated with smaller fragments (approximately 12-14 kDa), and some occasionally with larger fragments (approximately 55-57 kDa). Partial amino acid sequences were determined for the smaller photolabelled fragments and other peptides. On Western immunoblots, affinity-purified antibodies against a synthetic peptide with a sequence matching part of that of the approximately 12-14 kDa photolabelled material reacted with intact PDE and the approximately 12-14 kDa and approximately 55-57 kDa fragments. Several partial cDNA clones encoding the cGMP-stimulated PDE were isolated from a Lambda Zap II bovine brain cDNA library. Deduced amino acid sequence from one cDNA clone, lambda cGS 3-1, as well as the partial sequence of the approximately 12-14 kDa and other fragments, exhibited considerable identity with amino acid residues 311-921 of the cardiac cGMP-stimulated PDE (Trong et al., 1990), including the putative cGMP-binding domain (Charbonneau et al., 1990). These results further define this cGMP-binding domain and suggest that different cGMP-stimulated PDEs will exhibit considerable homology, at least in their cGMP-binding region(s) and catalytic domains.

3',5'-Cyclic-GMP Phosphodiesterases↗