[Effect of background factors concerning both elderly persons and their families with regard to the caregiver burnout in the home].

A cross sectional survey was performed to quantify factors that exhaust caregivers. We report that the degree of difficulty for caregivers correlated well with the burnout score (r = -0.517; p < 0.001), but the correlation between caregivers' burnout score and the level of their patient's basic ADL was lower (r = -0.317; p = 0.014). In this paper, we investigated other factors related to exhaustion. Caregivers' burnout score correlated with their age. The level of disease that caregivers complained increased burnout score. The need for nocturnal care and continuous observation, as well as rejection of aid burned out caregivers. Multiple regression analysis clarified that significant independent contributing factors for burnout score were help with toilet use, nocturnal aid and diseases suffered by caregivers.

[Effect of the level of basic activities of daily living on home caregiver burnout].

To relieve the stress of caregivers, it is critical to identify and classify the burden factors in the elderly patients. In order to determine the factors that exhaust caregivers, a cross sectional survey was done. The study employed a self-recording questionnaire form which included the Pines' burnout scale and the level of patient's basic activities of daily living (BADL). Seventy-three caregivers filled in the questionnaire. They reported the difficulty of care for an elderly patient in the home, and the degree of the difficulty correlated well with the burnout score (r = -0.517; p < 0.001). The caregivers' burnout score did not correlate so well with the level of their patient's BADL (r = -307; p = 0.014). Among the factors in BADL, aid for toilet use, feeding, sitting, and transferring raised the burnout scale. On the other hand, assistance for bathing and dressing did not correlate with the burnout score. On multiple regression analysis using the background factors for the burnout score as explanatory variables, aid for feeding and sitting were significant independent contributing factors. Since it became clear that the caregivers in the home were almost burnt out owing to the aid they need to give for the elderly person's BADL, attempts should be done to reduce their burden as soon as possible.

Optimal sampling interval and edge detection algorithm for measurement of blood vessel diameter on a cineangiogram.

RATIONALE AND OBJECTIVES: The authors studied the effects of image magnification and the type of edge detection filter on the precision of measuring blood vessel diameters on coronary angiograms. METHOD: A blood vessel phantom containing five channels of various diameters filled with contrast medium was filmed. The magnifications examined were x4, x10, and x20, and the edge detection filters used were the first derivative, second derivative, composite, and entropy filters. The regression line y = a+bx was introduced, where x represents the nominal diameter and y the diameter measured by the edge-detection filters. Determination criteria were the offset, slope, and residual variance from the regression equation. RESULTS: The best value among three criteria was obtained with a magnification of x10 or x20. The entropy filter gave the best value of slope and residual variance. The composite filter gave the best value of offset. CONCLUSION: The most precise measurement is obtained when the entropy filter and a magnification of x10 or x20 are applied.

[Clinical evaluation of finger blood pressure measurement devices for home-use].

We evaluated the accuracy of two types of finger blood pressure (BP) measurement devices for home-use (EW276 H, NATIONAL Ltd. and HEM 804F, OMRON Ltd.) by comparing BP values with upper-arm BP measured with a standard mercury column sphygmomanometer in 28 elderly subjects (13 Hypertensives and 15 normotensives). The correlation coefficient of systolic BP value and that obtained by each method was R2 = 0.5 for EW 276H and R2 = 0.6 for HEM 804F. The higher the systolic BP, the greater was the difference between the upper-arm and finger BP values. The magnitude of the difference between finger and upper-arm values for systolic BP did not correlate with pulse wave velocity. An underestimation of the finger BP device in systolic BP was 23.8 mmHg in hypertensives and 7.6 mmHg in normotensives for the EW 276H, and 15.3 and 3.5 mmHg, respectively for the HEM 804F. This study demonstrated a large difference between the finger BP value measured with the home-use devices and upper-arm BP value measured with a standard mercury sphygmonanometer in elderly hypertensive patients. The difference may be due not only to atherosclerotic change, but also to methodological factors related to finger BP measurement.

Traumatic disruption of bilateral vertebral arteries and internal carotid arteries: case report.

A case of traumatic disruption and dissection of the bilateral vertebral arteries and internal carotid arteries is reported. Ligation of bilateral arteries was performed for active bleeding. Anticoagulant therapy was selected to prevent thromboembolism and thrombotic occlusion of the dissected internal carotid arteries.

[A staged surgical treatment of an abdominal and iliac aneurysm associated with hydronephrosis and urinoma: report of a case].

Hydronephrosis and urinoma are extremely rare complication of the abdominal aneurysm. A case of the aorto-iliac aneurysm associated with right hydronephrosis and urinoma is reported. The patient is 71 year-old female. She was admitted because of right lower abdominal pain. A diagnosis of the infrarenal abdominal aneurysm with involvement of the common iliac artery and right hydronephrosis due to ureter obstruction was made. A leakage of urine from right renal pelvis (urinoma) was also confirmed. A staged treatment for hydronephrosis was selected. At first, percutaneous nephrostomy was made under ultrasonographic guidance. Urinoma was completely disappeared thereafter. Two weeks later, the aneurysm was replaced with a Y-shaped Dacron graft and the right ureter was mobilized from the perianeurysmal fibrous tissue. On the 35th postoperative day, balloon ureteroplasty was performed through the nephrostomy catheter. Three months after operation, nephrostomy catheter was successfully withdrawn because of improved urinary passage through the right ureter. We emphasize the efficacy of staged surgical treatment combined with percutaneous nephrostomy for the abdominal aneurysm associated with hydronephrosis.