Biomedical subjects

T Harada

Publications and source records attributed to T Harada.

1,427 records · Page 80Linked to original sources

PubMedDate not supplied

Extensive application of epidural anesthesia and analgesia in a university hospital: incidence of complications related to technique.

BACKGROUND AND OBJECTIVES: The authors report the role of epidural anesthesia and analgesia (EAA) and the incidence of epidural puncture-related complications in a university hospital in Japan. METHODS: Epidural anesthesia and analgesia was the major (39.7%) technique when administering 40,010 anesthetics. For the upper and the lower abdominal procedures, EAA was the major anesthetic technique in 79.5%, and 71.1% of these were carried out without potent inhaled anesthetics or long-acting muscle relaxants, and without endotracheal intubation. RESULTS: Epidural anesthesia and analgesia-related complications included failure to produce anesthesia on the first attempt (4.1%), bleeding/intravascular cannulation (0.67%), unintentional dural puncture (0.61%), paresthesia (0.16%), and local anesthetic toxicity (0.12%). CONCLUSIONS: The incidence of EAA-related complications was greater with lumbar than with thoracic puncture. Four patients had transient neuropathy related to epidural puncture, but no serious neurologic complications occurred.

Analgesia, Epidural↗

PubMedDate not supplied

Prolonged artificial liver support in a child with fulminant hepatic failure.

In Japan, liver transplantation from brain dead donors has not yet started. The authors present the first report of a clinical experience with a child with fulminant hepatic failure in whom the combined treatment of plasma exchange and continuous hemodiafiltration using a high-performance polymethylmethacrylate membrane was used successfully to sustain life for a period of as long as 54 days before liver transplantation from a living donor could be performed. The combination of plasma exchange and continuous hemodiafiltration appeared to maintain blood coagulation and level of consciousness effectively. Although the combined use of plasma exchange and continuous hemodiafiltration is still unsatisfactory as an artificial liver support, the authors suggest that this technique may be useful to support the life of a child who awaits liver transplantation.

Biocompatible Materials↗

PubMedDate not supplied

Multimodal treatment of stage IVa hepatocellular carcinoma.

BACKGROUND/AIMS: The effectiveness of multimodal therapy for Stage IVa hepatocellular carcinoma was investigated. MATERIAL AND METHODS: Between 1982 and 1994, 40 patients with primary Stage IVa tumors were treated in our clinical unit. RESULTS: The overall survival rate was 79.7% at 1 year, 37.0% at 3 years, and 20.8% at 5 years. However, the most successful multimodal therapy, a combination of hepatectomy, embolization, and ethanol injection, achieved significantly better results (92.9% at 1 year, 59.6% at 3 years, and 47.7% at 5 years). This improved survival could still be obtained by multimodal therapy, even when surgical resection was incomplete. CONCLUSION: These results suggest that multimodal therapy including hepatectomy can be recommended for improving the survival of patients with Stage IVa hepatocellular carcinoma.

Aged↗

PubMedDate not supplied

[The relationship between professional autonomy and demographic and psychological variables in nursing].

The purpose of this study is to investigate the relationships of professional autonomy in nursing with demographic and psychological variables. The measure of professional autonomy in nursing is constructed by five factors, "Cognition", "Performance", "Concrete judgement", "Abstract judgment" and "Independent judgment", respectively and interpreted to represent the professional work abilities of nursing. Age, years of experience of nursing, arrangement of work place in the hospital, position level and educational background of nursing are selected as demographic variables. Psychological variables used in this study were intention to continue at work as a nurse, work satisfaction and motivation, self confidence and self evaluated aptitude toward nursing. Three-hundred and seventy professional nurses in the public hospital were administered a questionnaire including the five-point scale for professional autonomy in nursing and several demographic and psychological variables. The main results were as follows: (1) Each of the sub-scale scores of professional autonomy in nursing had significant and positive correlations with age, years of experience, work satisfaction and motivation, self confidence and aptitude toward nursing. (2) Nurses worked at the intensive care unit and operation room were significantly higher scores of professional autonomy in nursing than the nurses at the ward and the outpatient clinic. (3) Professional autonomy in nursing was totally increasing with the increase of nurse's position and years of experience. (4) Self confidence, position level and the kind of nursing license were the most explicable variables of professional autonomy in nursing.

Adult↗

PubMedDate not supplied

Injection sclerotherapy for gastric varices using N-butyl-2-cyanoacrylate and ethanolamine oleate.

BACKGROUND/AIMS: Tissue adhesive agents, such as the cyanoacrylates, have been used as an alternative to conventional sclerotherapy to treat gastric varices, but the long-term efficacy of this approach has not been determined. We evaluated the efficacy and long-term outcome of injection sclerotherapy with n-butyl-2-cyanoacrylate and ethanolamine oleate in 16 patients with gastric varices. METHODOLOGY: We evaluated the effect of injection sclerotherapy in 16 Japanese patients with gastric varices. Injection sclerotherapy was performed on an emergency basis in 6 patients, an elective basis in 5 patients, and as prophylaxis in 5 patients. RESULTS: No bleeding was observed in the 7 patients in whom gastric varices disappeared during the 51 month follow-up period. The non-bleeding rate after treatment was significantly higher in this group than in the 9 patients in whom gastric varices did not disappear (p<0.05). Acute bleeding was stopped in 5 (83.3%) of 6 patients. The single failure was a patient in whom the sclerosant could not be injected into the gastric varices. No serious complications, such as emboli in other organs, were observed. CONCLUSION: The results suggest that this therapy is a safe and useful treatment for gastric varices and that the goal of injection sclerotherapy should be the disappearance of gastric varices.

Disease-Free Survival↗