This study aimed to describe the relationship between inappropriate conditions due to multiple puncture attempts for catheterization and thrombus formation with subcutaneous edema at catheter failure by qualitative analysis and ultrasonography. Seven categories were extracted, and two stories were identified using qualitative-descriptive analyses. First, when attempting multiple insertions, ＜puncture sites＞ were chosen, such as the ulnar side and dorsum of the hand, while ＜visual judgment of target vein＞ was difficult, and the ＜posture at insertion＞ was contorted. The catheters were not inserted parallel to the sagittal plane, and the echo image confirmed that ＜intravascular position of catheter tip＞ were not parallel to the vessels. Second, with IV cannulation on the radial side, during manipulation of the ＜securement by dressing films＞, the mesh part of the IV dressing covered the connector area and caused it to sink into the patient’s skin in the ＜peripheral condition of the hubs/connectors attached to the apparatus＞. These phenomena were observed in many echo images in which the tip of the catheter was placed in the upstream direction of the blood vessels. Our results suggested that the posture of the body during insertion and the securement methods could affect thrombus and edema formation, since mechanical stimuli affected the blood vessels and subcutaneous tissue.
Estimate intentional joint angle easily and accurately is important for developing a powered prosthetic hand which can realize upper limb amputee’s intentional motion. We proposed the joint angle estimation method using the muscle bulge movement on the forearm skin surface derived from the deformation of the muscle while muscle contraction. We hypothesized a simple relationship between the muscle bulge movement longitudinally along a muscle and the corresponding joint angle, because the muscle contraction causes the change in the joint angle. In this paper, we evaluated the feasibility of the muscle bulge movement for wrist joint angle estimation by confirming the signal characteristics of the proposed signal. From the experimental results with five non-amputated subjects, we extracted a linear relationship from the raw data with a high determination coefficient as 0.94. Using the function eared from the raw data, we achieved the joint angle estimation error as 8.05［°］which is similar to that of using surface EMG in related work. We will develop a joint angle control method using the muscle bulge movement for a powered prosthetic hand with upper limb amputee.
This quasi-experimental study aims to determine the effectiveness of different cleaning agent removal methods in removing skin dirt from the forearms of healthy women. After removal of skin dirt, the detergent was removed in three different methods, i.e., wiping off from the periphery to the center（WIPE A）, from the center to the periphery（WIPE B）, and in circular motions shifted outward from the center（WIPE C）. A total of five sites, of which one site included an area where oil-based lipstick was applied as a dirt substitute, were evaluated. The effectiveness of skin dirt removal by the different methods, involved determining the difference（Δa＊values）calculated between pre and post-intervention skin colours. The number of significant differences between the four-cleaning agent removal methods at each measurement site was counted, and the total number of participants for each cleaning agent removal methods was calculated as a total score. The WIPE C method demonstrated a higher total five-site scores than the WIPE A and WIPE B methods. Among the procedural variations of the wiping methods, circular motions shifting outward from the centre spread less dirt and was most effective in skin dirt removal.
This study examined factors associated with severe skin disorders after extravasation. Among 256 patients who received intravenous drip infusion of antineoplastic agents from April through September 2014, the 25 patients who experienced extravasation were analyzed. Measurements of skin temperature by thermography and macroscopic observation were performed during drip infusion to each patient. The severe group（12 patients）was defined as patients showing induration or blistering at the next hospital visit. The remaining 13 patients constituted the mild group. Various factors were compared between groups. All study protocols were approved by the Kanazawa Medical University Ethics Committee. The severe group was characterized by longer administration of vesicant or irritant agents after appearance of a thermographic low-temperature region suggesting extravasation（severe group, 28 min；mild group, 6 min；P=0.017）, lack of swelling during administration（severe group, 92%；mild group, 46%；P=0.03）, and lower age（severe group, 59.4 y；mild group, 71.2 y；P=0.037）. The results of the present study suggest that the factor associated with severe skin disorder after extravasation was a long duration of extravasation due to a lack of recognition of swelling after the first appearance of symptoms.
The purpose of this study is to analyze the experiences of the patients who underwent Robot Assisted Laparoscopic radical Prostatectomy（RALP）and to clarify their expectation and anxiety about the advanced medicine for prostate cancer. A semi-structured interview was conducted on 8 patients who underwent RALP for prostate cancer. Through the analyses of the records, these findings were obtained. Patients and their families accepted the advanced surgical treatment, with hearing their friends’ experiences and getting information through the internet. They expected its minimally invasiveness, accuracy and high curability. They were satisfied with the earlier recovery from the surgical procedure than their prediction. In the short hospitalization period to build up a relationship of trust with patients, such information from the patients’ point of view will provide important findings to provide high-quality nursing. It is suggested that a hands-on individual consultation and understanding degrees is required.
Background：One of the most serious complications of nasogastric tubes（NGTs）is inaccurate placement. A number of easy techniques have been developed to confirm accurate NGT placement；however, these methods are lacking in accuracy. Chest x-rays are the most accurate method of confirming NGT placement, yet x-rays are often inconvenient. In this study, we examined whether a hand-carried ultrasonography device（HUD）could provide an accurate and convenient method for confirming the placement of NGTs. Methods：We used HUD to confirm NGT placement in a series of 10 patients. NGT positioning was evaluated in both the neck and epigastric regions. Visibility was improved by aspirating stomach contents while imaging both the neck and epigastric regions and placing the patient in the left decubitus position while imaging the epigastric region. Results：In all 10 patients, the placement of the NGT was verified. In 80% of patients（8/10）, the NGT was visualized in the neck. In 80% of patients（8/10）, the NGT was visualized in the epigastric region. HUD was able to visualize even small-bore NGTs, with sizes ranging from 8-Fr to 12-Fr. Conclusions：The hand-carried ultrasonography device is a reliable and convenient method for confirming placement of NGTs.
The activity of matrix metalloproteinases（MMPs）associated with progression and inhibition of wound healing is expected to be a biomarker to reflect the wound inflammatory status. However, a method has not been developed to visualize the activity distribution of MMPs. In this study, we developed a novel distribution analysis method by combining wound blotting and zymography techniques. Wound blotting samples were collected from full thickness wounds of mice. A gelatin gel was reacted with the wound blotting sample, and then stained. Image processing of gel images clearly showed the distribution of MMP activity, although the detection sensitivity of MMP activity was lower than in conventional electrophoretic zymography. The distributions of MMP activity were observed on the wound edge and bed. These results suggest that the different distribution patterns of MMP activity, which translocates from the wound edge to bed, and the continuous distribution on the wound edge during the healing period reflect different wound inflammatory statuses.
Background：High-frequency ultrasonography is used to non-invasively visualize the skin. However, few studies have focused on the association between ultrasound images and actual histology. Here we focused on the comparison of high-frequency ultrasound images and their actual histology using Cesarean scar tissue removed during delivery. Methods：This study included 12 pregnant women who provided a written informed consent. The ultrasound images of scars were captured prior to delivery using a high-frequency ultrasound device. Scars were sampled by an obstetrician, and collagen and elastin staining were performed on the samples. The amount of collagen or elastin was estimated by an intensity analysis using immunohistochemistry images. Results：Only low-echogenicity signals were observed in the scar tissue, although a tight structure was present. Echogenicity was significantly correlated with the elastin-positive area but not with the collagen-positive area. Conclusion：The echogenicity of ultrasound images appeared to be more closely associated with the amount of elastin than with the amount and/or density of collagen fibers.
INTRODUCTION：Many studies have shown that human organs are a deterministic chaos. However, it remains unclear whether this is true for the human fetus and mother. We aimed to clarify whether the fetus and mother are a deterministic chaos or not. METHODS：We measured heart sounds of four human fetuses and their mothers during 11th-36th week of gestation using an ultrasonic Doppler apparatus. We investigated non-linearity of the data using the surrogate method. Data modified by three surrogate methods：Random shuffle, Fourier shuffle and Period-shuffle, were used in the study. We conducted a chaotic analysis to recognize the largest Lyapunov exponents（λ1）and the attractor. RESULTS：The result of calculation of correlation dimension is five. λ1 of the original data was significantly different from that of each surrogate data. Fetuses and mothers showed positive λ1 from 11th to 36th week of gestation. Moreover, the attracters were clearly recognized for fetuses and mothers. The results indicate these data deterministic chaos with nonlinear dynamics. DISCUSSION：These results indicate that fetus and mother are a deterministic chaos, and that fetus and mother showed the self-organization ability to interact nonlinearly.
This study is improvement of nursing care providing system from cell nursing system that is taken from the cell production system in manufacturing. Cell production system is different from line production system as belt conveyor system. One worker or one group operate all of production process. Under the cell nursing system nurses are assigned patients’ rooms in charge for all caring tasks on daily bases. In addition, other tasks such as information gathering and sharing, and conference are carried out in patients’ rooms rather than at staff station. As a result of being closer to patients, nurses are able to catch sings from patients easily, and then are able to provide forestalling care to patients. Some of positive impacts are the reduced number of Nurse Call Volumes. In this paper are discussed based on data of the Location Detecting System.