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Osamu Okada

Publications and source records attributed to Osamu Okada.

8 recordsLinked to original sources
PubMed2005

Effectiveness and safety of the thrombolytic therapy for acute pulmonary thromboembolism: results of a multicenter registry in the Japanese Society of Pulmonary Embolism Research.

OBJECTIVE: To assess the effectiveness and safety of thrombolytic treatment for acute pulmonary thromboembolism (APTE), especially in the hemodynamically stable patients with right ventricular afterload stress. METHODS AND RESULTS: In a total of 221 patients with APTE, the association between thrombolytic treatment and the clinical outcomes were investigated. Thrombolysis was given to 121 patients (Thrombolytic Group), and the remaining 100 patients were treated with anticoagulation alone (Anticoagulation Group). In both patients with prolonged shock and patients who were hemodynamically stable without right ventricular afterload stress, the rate of death and recurrence of APTE in Anticoagulation Group were similar to those in Thrombolytic Group. In patients with right ventricular afterload stress, better outcomes were observed in Thrombolytic Group than in Anticoagulation Group, although the difference did not reach statistical significance. There was no significant difference in the rate of major bleeding episode between these two groups. CONCLUSION: Our results suggested that performing thrombolytic treatment in APTE patients with right ventricular afterload stress should be considered even in Japan.

Acute Disease↗
PubMed2005

Electronic clinical path system based on semistructured data model using personal digital assistant for onsite access.

Clinical Paths (Paths) have been introduced by different hospitals for patient care management. An Electronic Clinical Path (ECP) with onsite access provision seems to improve the efficiency of medical staffs because they can share vast medical information about patients at a time and also can reuse accumulated data easily, which is impossible with paper-based Path. Data model is the basis for implementing ECP. However, there is no established model for ECP. The purpose of this study is to introduce a model for ECP and implement an ECP with onsite access system. We introduced a Semistructured Data Model (SSDM) for ECP, and implemented a Web application system based on this model using Personal Digital Assistant (PDA) as inputting device. Our system functioned as expected with wireless LAN, and users handled the data on bedside using PDA. By introducing SSDM, we showed the correspondence between schema of Paths and implementation of ECP.

Access to Information↗
PubMed2005

Clinical path modeling in XML for a web-based benchmark test system for medication.

Many hospitals have introduced the Clinical Path (Path) to improve medical procedures. A Path is a way to manage care and check lists for a certain disease, providing a useful tool for hospital management. Paths can help hospitals reduce the duration of hospitalization and variations in care of patients while increasing hospital revenue. Nowadays, Paths are made by each hospital and there is no standard format. Benchmark testing between Paths used by different hospitals is important for evaluating medical practices, in order to develop and improve more effective practices. However, as the formats used in Paths are not standardized, benchmark testing of Paths is no easy task. To start benchmark testing of Paths, we compare medication in Paths and introduce description rules of medication in XML. Based on these, we developed a prototype system that enables us to compare the difference of medications in Paths prescribed between multiple of hospitals.

Benchmarking↗
PubMed2003

Interfacial deformation between an impacting water drop and a silicone-oil surface.

Detailed observations have been conducted on the interfacial deformation of a silicone oil surface and a water drop falling on it. Eleven kinds of silicone oils with wide variations of kinematic viscosity, nu(T)=1-10(5) mm(2)/s, have been tested. The oil surface is disturbed by a water drop with a diameter d(L)=3.1 mm, which falls freely on it from a height of 100-1000 mm. Special attention has been directed to the maximum depth of the cavity formed on the oil surface D(M) and to the maximum diameter of the water drop spreading on the oil surface d(M). We have categorized the configurations of the oil cavity into seven patterns, and those of the water drop at the oil-water interface into five patterns. The maximum cavity depth D(M)/d(L) can be well correlated by a dimensionless group Re(TL)We(TL), where Re(TL) is Reynolds number based on d(L) and nu(T) and We(TL) is Weber number with the water density and surface tension of oil. The maximum diameter of the impacting water drop d(M)/d(L) can be correlated by the Reynolds number with a viscosity of water (Re(L)) and the Ohnesorge number (Oh). Moreover, the condition under which the impacting water drop is smashed into pieces has been also examined based on Re(L) and Oh.

Journal Article↗
PubMed2003

Recent developments in diagnostic imaging techniques and management for acute pulmonary embolism: multicenter registry by the Japanese Society of Pulmonary Embolism Research.

OBJECTIVE: There are many reports on the diagnosis and management of acute pulmonary embolism (APE), but there have been no investigations concerning the actual conditions in which recent developments in diagnostic imaging techniques and therapies have been applied in clinical practice. The present study was designed to investigate the changes in diagnostic imaging techniques and therapies for APE. METHODS AND PATIENTS: Three hundred and nine APE patients diagnosed during January 1994-October 1997 (Group 1) were compared with 257 APE patients diagnosed during November 1997-October 2000 (Group 2) in terms of the diagnostic imaging techniques and therapies for APE. RESULTS: Compared with Group 1, pulmonary angiography and contrast-enhanced computed tomography were more frequently performed for diagnosis in Group 2 [45.3% vs 56.8% (p = 0.0069) and 13.9% vs 57.6% (p < 0.0001), respectively]. Heparin and vena cava filter were used more often in Group 2 [74.4% vs 82.1% (p = 0.033) and 18.4% vs 33.9% (p < 0.0001), respectively]. The frequency of thrombolytic therapy was unchanged between the two groups. Warfarin use in discharged patients increased from 71.9% to 83.8% (p = 0.0022). However, the examination rates for deep vein thrombosis (DVT) were low (60.8% in Group 1 and 65.4% in Group 2, p = 0.29) and unchanged using any imaging techniques. CONCLUSION: The diagnostic imaging techniques for APE increased in variety and the management has improved, while the diagnosis for DVT remains unchanged.

Acute Disease↗
PubMed2002

Incidence and clinical characteristics of chronic pulmonary thromboembolism in Japan compared with acute pulmonary thromboembolism: results of a multicenter registry of the Japanese Society of Pulmonary Embolism Research.

The incidence of acute pulmonary thromboembolism (APTE) in Japan is quoted as being extremely low compared with the United States, and the incidence and clinical characteristics of chronic pulmonary thromboembolism (CPTE) in Japan is unknown, so this study investigated these aspects of CPTE in 309 patients with APTE and 68 patients with CPTE. The ratio of the incidence of CPTE to APTE was 0.22 and there was no significant difference in age or sex between the APTE and CPTE patients. All of the predisposing factors for pulmonary thromboembolism, except for thrombophilia, were more frequently seen in the patients with APTE. There are some differences in the incidence and clinical characteristics of CPTE compared with APTE between Japanese and American patients in Japan, suggesting that the pathogenesis of CPTE in Japan may differ from that in the USA.

Acute Disease↗