Biomedical subjects

H Horio

Publications and source records attributed to H Horio.

At least 37 records · Page 2Linked to original sources

PubMed2000

Mixing collagen with fibrin glue to strengthen the sealing effect for pulmonary air leakage.

BACKGROUND: To strengthen the sealing effect of fibrin glue for pulmonary air leakage, atelocollagen was mixed with the glue and the mixing effect was examined. METHODS: A mixture of fibrinogen and thrombin with atelocollagen was used as a test sample. The concentrations of atelocollagen were adjusted to levels of 0%, 0.375%, 0.75%, 1.1%, and 1.5%. We next performed air leakage tests on a plastic cap with pin holes and swine lung and also measured the elasticity and the adhesion strength. RESULTS: The pressure required to rupture the sealant on a plastic cap with pin holes increased as the concentration of atelocollagen increased, and the bursting pressures were significantly higher in the glue with 0.75%, 1.1%, and 1.5% of atelocollagen than in the glue without atelocollagen (p < 0.01 and p < 0.001). The air leakage pressure on the swine lung was significantly higher in the glue with 0.375%, 0.75%, and 1.1% of atelocollagen than in the glue without atelocollagen (p < 0.05 and p < 0.01), and it was the highest with 0.75%. The elasticity of the glue significantly increased as the concentration of atelocollagen increased (p < 0.001). However, the adhesion strength of the glue significantly decreased as the concentration of atelocollagen increased (p < 0.05 to p < 0.001). CONCLUSIONS: The mixing of atelocollagen with fibrin glue more effectively sealed pulmonary air leakage due to an increased elasticity of the glue while its adhesion strength decreased. The optimal concentration of atelocollagen in the fibrin glue to obtain the best sealing effect was 0.75%.

Animals↗

PubMed2000

Double stenting for esophageal and tracheobronchial stenoses.

BACKGROUND: We examined the complications and outcomes of placing stents for both esophageal and tracheobronchial stenoses. METHODS: We placed stents for both esophageal and tracheobronchial stenoses in 8 patients (7 with esophageal cancer and 1 with lung cancer). Covered or noncovered metallic stents were used for the esophageal stenoses, except in 1 patient treated with a silicone stent. Silicone stents were used for the tracheobronchial stenoses. The grades of esophageal and tracheobronchial stenoses were scored. RESULTS: All patients experienced improvement of grades of both dysphagia and respiratory symptoms after stent therapy. The complications were: (1) 2 patients suffered respiratory distress after placement of the esophageal stent because of compression of the trachea by the stent; and (2) 3 patients developed new esophago-tracheobronchial fistulae, and 2 patients had recurring fistula symptoms because of growth of preexisting fistulae after the stent placement, which were caused by pressure from the 2 stents. Despite the fistulae, the 5 patients treated with covered metallic stents did not complain of fistula symptoms, but 2 patients treated with noncovered metallic or silicone stents did complain. CONCLUSIONS: For patients with both esophageal and tracheobronchial stenoses, a stent should be introduced into the tracheobronchus first. Because placement of stents in both the esophagus and tracheobronchus has a high risk of enlargement of the fistula, a covered metallic stent is preferable for esophageal cancer involving the tracheobronchus.

Adult↗

PubMed2000

Assisted pressure control ventilation via a mini-tracheostomy tube for postoperative respiratory management of lung cancer patients.

Assisted pressure control ventilation (PCV) via a min-tracheostomy tube (MTT) was conducted to improve gas exchange and reduce the work of breathing of lung cancer patients after surgery. Thirty-two patients with lung cancer underwent lobectomy and were managed postoperatively by assisted PCV via an MTT. On the basis of a simulation study using a lung model for clinical use, we set the inspiratory pressure to 20 cmH2O and inspiratory time to 1.0 sec to produce a 450-ml supported volume via the MTT per breath. The blood gases and respiratory rate of each patient were measured under three sets of conditions: PCV via an MTT transtracheal oxygenation (TTO) via an MTT and a Venturi face mask with the same FiO2. After PCV via an MTT overnight, the blood gases in the room air were measured 2.5 h after withdrawing PCV. In order to determine the effect of PCV via an MTT on gas exchange after PCV withdrawal, 32 other age and sex-matched lung cancer patients, who had undergone lobectomy and oxygenation via a face mask alone after surgery, were used as historical controls. The simulation study showed that the ventilated volume provided by assisted PCV via an MTT was about half that provided via a conventional endotracheal tube, even in the presence of air leakage. The clinical application showed that the ventilated volume obtained with the PCV via an MTT was significantly higher than that with spontaneous breathing (P<0.001). PCV via an MTT increased the PaO2 and reduced both the PaCO2 and respiratory rate significantly in comparison with TTO via an MTT and a face mask (P<0.001). After PCV withdrawal the morning after surgery, the PaO2 of the PCV group was significantly higher than that of the historical controls (P<0.001). No postoperative pulmonary complications were observed in either the PCV or the control groups, however. In addition, no complications or morbidity were seen related to either MTT insertion or PCV via an MTT. Assisted PVC via an MTT increased the tidal volume, improved the gas exchange, reduced the respiratory rate by providing adequate ventilatory support and increased the PaO2, even after withdrawal following lung surgery. Even though we did not observe any benefit of clinical outcome with PCV via an MTT in the present study, this procedure appears to be a potentially useful respiratory management modality for patients with high risk of postoperative pulmonary complications.

Adult↗

PubMed2000

Multiple pulmonary infarctions associated with lung cancer.

We present a case of right lung adenosquamous cell carcinoma that had obstructed the main pulmonary artery and superior pulmonary vein, causing multiple pulmonary infarctions in the right upper and middle lobes. Multiple peripheral pulmonary nodules showed clinical features that are characteristic of pulmonary infarction: rapid appearance and gradual reduction in size, pleural-based parenchymal density with a truncated apex and a round nodular shadow with a blurred margin and a centrally directed linear shadow. The nodules were more intense than the primary tumor in both T1- and T2-weighted magnetic resonance imaging (MRI). We conclude that pulmonary infarction can look like a nodule when lung cancer invades both the pulmonary artery and vein and that such cases can be distinguished from pulmonary metastasis by MRI, computed tomography and a series of radiological examinations.

Aged↗

PubMed2000

[Mycobacterial infection within a pulmonary bulla].

The patient was a 31-year-old man. Chest X-ray films and computed tomographic (CT) scans disclosed fluid retention within an 11-cm diameter pulmonary bulla that had been detected in the upper lobe of his left lung 1 year earlier. CT films also disclosed a 1.5-cm nodular lesion in the apical segment of the left lower lobe. The patient had no symptoms and laboratory examinations disclosed no signs of inflammation. Thoracoscopic examination revealed a yellow-turbid fluid with caseous necrosis within the bulla. Although Ziehl-Neelson staining of a bulla tissue specimen was 1 on the Gaffky scale, culture of the fluid was negative. Histologically, the bulla wall and pulmonary nodule revealed granuloma with caseous necrosis, thus yielding a diagnosis of mycobacterial infection within the bulla and lung. Following an operation, anti-tuberculous drugs were administered and the patient was well without recurrence of tuberculosis 30 months afterward. We concluded that infectious bulla with few or no symptoms and limited inflammatory findings may occasionally be caused by Mycobacterium infection.

Adult↗

PubMed2000

Granulation stenosis caused by a Dumon stent placed for endobronchial tuberculous stenosis.

Two patients with cicatric tracheobronchial stenosis caused by tuberculosis who suffered granulation stenosis after placement of a Dumon stent are reported. Dumon stents, which were long enough to cover the stenotic sites, were placed in the trachea and left main bronchus of each patient. Granulation tissue grew at both edges of the stent 3 or 4 months after stent placement, which caused restenosis and necessitated removal of the stents. The authors conclude that a Dumon stent for treatment of tracheobronchial stenosis caused by tuberculosis can cause granulation stenosis at the edges of the stent.

Adult↗

PubMed2000

[Low body mass index and exercise capacity in patients with chronic obstructive pulmonary disease (COPD)].

This study examined retrospectively the relationships between body weight and exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Seventeen patients with a %FEV1 less than 55% (mean +/- SD 36% +/- 8.8%) and minimum body weights of the body mass index (BMI) less than 20 (17.3 +/- 1.7) performed incremental exercise testing using a treadmill. Seventeen %FEV1-matched control patients with normal body weights were selected. There were no significant differences in the patients' characteristics or their pulmonary function tests (including vital capacity, carbon monoxide diffusing capacity, and arterial blood gases). Low BMI patients Is this the weaning of (67.8 +/- 6.3 years old) were younger than the control patients (73.1 +/- 8.5 years old), but the difference was not statistically significant. The exercise capacities of low BMI patients were significantly superior to those of the control patients (316.5 +/- 171.5 seconds vs 204.1 +/- 116.3 seconds, p = 0.038) and total walking distance without statistical significance (194.9 +/- 117.0 m vs 125.7 +/- 98.0 m, p = 0.071). Also, low BMI patients achieved higher maximal minute ventilation volume during exercise than the controls. The major factor limiting exercise in patients with low BMI was ventilation. Moderately low body weight may not be a risk factor in Japanese COPD patients.

Aged↗

PubMed1999

Intrathoracic light-assisted anterior limited thoracotomy in lung cancer surgery.

We recently developed an intrathoracic light-assisted anterior limited thoracotomy (ILAALT) for use in lung cancer surgery. A skin incision 12cm long is made below the breast, then the pectoral major muscle is divided, and the fourth intercostal space is opened with a disconnection of the anterior cartilagenous portion. The posterior skin, including the serratus anterior muscle, is drawn posteriorly using a retractor. To illuminate the posterior and apex portions of the thoracic cavity, a flexible fiber light is introduced into the thoracic cavity through the eighth intercostal space at the posterior axillary line. These techniques provided adequate exposure and sufficient illumination in the thoracic cavity, thus making surgery easy for most thoracic applications. Using this approach, we undertook 28 lung resections with a mediastinal nodal dissection for lung cancer (24 lobectomies, 2 bilobectomies, and 2 pneumonectomies) without difficulty. The mean intrasurgical blood loss was 217ml, the operative time 262min, and chest tube drainage duration 2.3 days. Except for one case, no patients required a blood transfusion. All patients underwent continuous epidural anesthesia until postoperative day (POD) 8. The mean time that other analgesic medication was required was 0.5 times per patient until POD 13, but none from POD 14 on. We thus conclude ILAALT to be low-invasive thoracotomy and is thus indicated for most types of lung cancer surgery, providing a reduction of pain as its main advantage.

Fiber Optic Technology↗

PubMed1999

Postoperative airway stenosis and stent therapy in carinal reconstruction for lung cancer.

A 48-year-old male had adenocarcinoma of the right upper lung lobe that invaded the lower trachea. The right upper lobe, the carina, and 5 rings of the lower trachea were resected. The carina was reconstructed using end-to-end anastomosis between the trachea and right intermediate bronchus, with the left main bronchus anastomosed to the side wall of the intermediate bronchus. Two months after surgery, the right intermediate bronchus developed bronchomalacia and the tracheal anastomosis granulatory stenosis. Bronchomalacia was treated with 2 expandable metallic stents, and granulatory stenosis with a Dumon stent. Although the silicone stent successfully dilated the granulatory stenosis, the metallic stents caused delayed glanulatory stenosis. We concluded that a metallic stent is not desirable for treating postreconstructive airway stenosis including bronchomalacia, whereas a Dumon stent may be effective.

Adenocarcinoma↗

PubMed1999

Two-stage operation for endobronchial lipoma and lung cancer using bronchoscopy and thoracoscopy in an elderly patient with chronic obstructive pulmonary disease.

We present an 82-year-old man with chronic obstructive pulmonary disease with endobronchial lipoma, obstructing the right lower lobe bronchus, and lung adenocarcinoma in the peripheral lung of the right upper lobe (clinically T1N0M0). The endobronchial lipoma was thus first removed by bronchoscopic snaring forceps and laser therapy, resulting in an improvement of the pulmonary function. One month later, the lung adenocarcinoma was removed using thoracoscopy. The postoperative course was satisfactory, and the patient is now doing well without any tumor recurrence 11 months after surgery. For elderly chronic obstructive pulmonary disease patients with endobronchial lipoma and T1N0M0 lung cancer, a two-stage operation, consisting of bronchoscopic resection followed by a thoracoscopic resection for lung cancer, was found to be a safe and effective method of treatment while maintaining sufficient pulmonary function.

Adenocarcinoma↗

PubMed1999

Gelatin-resorcinol-formaldehyde-glutaraldehyde glue for sealing pulmonary air leaks during thoracoscopic operation.

BACKGROUND: Intraoperative pulmonary air leakage is one of the most troublesome complications in video-assisted thoracoscopic surgical procedures. We developed a sealing procedure using gelatin-resorcinol-formaldehyde-glutaraldehyde (GRFG) glue for pulmonary air leaks during such operations. METHODS: Formaldehyde-glutaraldehyde (FG) jelly is prepared by mixing FG fluid with 2.5% sodium carboxymethyl cellulose to make the FG fluid viscous. We performed an adhesion-strength test to determine the optimum ratio of gelatin-resorcinol mixture to FG jelly and then conducted an air leakage test on swine lung to compare the sealing effect between fibrin and GRFG glues. To study the histotoxicity of the GRFG glue, the sealant was applied to injured rabbit lung, and the rabbits were followed for 1 day to 188 days. For clinical studies, we developed an endosyringe to apply the GRFG glue on the target site during video-assisted thoracoscopic surgical procedures and used this technique in 21 patients with intraoperative air leaks. In addition, the side effects of GRFG glue application were studied in 52 patients in whom glue was used in several ways during lung operations. RESULTS: The results of the adhesion-strength test favored a 2:1 gelatin-resorcinol to FG ratio. The mean pressure required to produce air leakage was significantly higher with GRFG glue than with fibrin glue (p<0.001). No critical histologic damage was seen in the rabbit lung, and the glue persisted on the lung surface for 188 days after sealing. Clinical application of the glue in 21 patients resulted in complete stoppage of air leakage during operation and long afterward, except in 1 patient with a late-onset lung fistula. The FG jelly helped prevent glue spillage at the target site, regardless of angle. A transient rise in temperature up to 38.60C was observed as a side effect 7 days after operation in 5 (9.6%) of the 52 patients. CONCLUSIONS: A GRFG glue using FG jelly seals pulmonary air leaks effectively, simply, and safely during video-assisted thoracoscopic surgical procedures.

Animals↗

PubMed1999

Granulocyte colony-stimulating factor-producing primary pericardial mesothelioma.

A 54-year-old male patient presented with a granulocyte colony-stimulating factor (G-CSF)-producing primary pericardial mesothelioma, while showing symptoms of congestive heart failure, a fever of 38 to 39 degrees C, and marked leucocytosis of 52.7 x 10(3) cells/mm3. The histopathologic diagnosis was established after autopsy. G-CSF production was confirmed by the expression of G-CSF mRNA in the tumor extract and the patient's high serum G-CSF concentration. The expression of G-CSF by benign and malignant mesothelial cells has already been reported. However, this is the first case report of G-CSF production in a pericardial mesothelioma.

Fatal Outcome↗

PubMed1999

Minimally invasive thymoma with extensive intravascular growth.

A 70-year-old male with grossly non-invasive thymic tumor associated with myasthenia gravis was subjected to thymothymectomy. Microscopic examination showed extensive intravascular tumor extensions into veins of thymic tissue and surrounding muscles and a minute direct invasion of the thymic tissue. Histologically, the tumor showed mixed-type thymoma with polygonal epithelial cells. These pathological findings indicated that the tumor cells extended mainly into vessels beyond the tumor capsule via tumor drainage veins rather than invading neighboring structures. After chemotherapy and mediastinal irradiation, the patient is now in complete remission of myasthenia gravis and is recurrence-free 15 months after surgery.

Aged↗

PubMed1999

Pain-relieving posterior rod fixation with segmental sublaminar wiring for Pancoast tumor invading the vertebrae.

We describe the case of a 44-year-old male patient with Pancoast lung cancer invading the vertebrae. Because irradiation did not relieve his symptoms, we conducted tumor resection with posterior rod fixation with segmental sublaminar wiring of the vertebrae. This enabled the patient to walk and to discontinue morphine immediately after surgery. Although the tumor recurred within the region of the fixation 4 months after surgery, the patient complained of no pain until his death. Although Pancoast lung cancer with extensive vertebral invasion cannot be cured surgically, posterior rod fixation with segmental sublaminar wiring with tumor resection can improve a patient's quality of life by providing immediate, long-term pain relief.

Adult↗

PubMed1999

Dumon stent placement via endotracheal tube.

BACKGROUND: Dumon stent placement requires use of a technically difficult rigid bronchoscope. A recently developed technique for placing a Dumon stent introduced via a conventional endotracheal tube is detailed herein. METHODS: The conventional endotracheal tube is inserted beyond the stenosis site; this procedure is observed with the use of a flexible bronchoscope with the patient undergoing general anesthesia. The Dumon stent is folded and inserted into the endotracheal tube and is introduced into the stenosis site with the use of a cylindrical-tipped stainless steel wire as a pusher. The endotracheal tube is withdrawn while the pusher is positioned to expand the stent at the stenosis site. Dumon stents of 12 to 16 mm in diameter were put in place using the present method in 5 cases of tracheobronchial stenosis. RESULTS: The mean time from endotracheal tube insertion to stent placement was 181 s. The present method positioned the Dumon stent more easily and safely than the original rigid bronchoscope because the endotracheal tube used was flexible. One patient, however, required a tracheostomy and surgical forceps to remove the stent 3 months after placement. CONCLUSION: While Dumon stent removal may require a rigid bronchoscope or tracheostomy, stents can be introduced without difficulty via a conventional endotracheal tube.

Aged↗

PubMed1999

Anterior limited thoracotomy with intrathoracic illumination for lung cancer: its advantages over anteroaxillary and posterolateral thoracotomy.

STUDY OBJECTIVE: We developed anterior limited thoracotomy (ALT) with intrathoracic illumination for curative resection of lung cancer. The present study evaluated the benefits of ALT by retrospective comparison with anteroaxillary thoracotomy (AAT) and posterolateral thoracotomy (PLT). DESIGN: Lung cancer patients, who underwent lobectomy via ALT (n = 28), AAT (n = 28), and PLT (n = 28), were matched by gender and age. Operating time, blood loss during operation, chest tube drainage volume 24 h after surgery, chest tube drainage duration, and vital capacity (VC) and chest pain from early to late postoperative period were studied for ALT, AAT, and PLT. Early postoperative chest pain was evaluated by a visual analog scale and analgesic requirements, and chronic pain was divided into five grades. RESULTS: No difference was observed in operating time among ALT, AAT, and PLT. ALT has the following advantages over PLT: (1) less blood loss during surgery (p < 0.05); (2) reduced postoperative drainage volume (p < 0.05) resulting in shorter chest tube drainage (p < 0.001); (3) diminished impairment of VC for 1 week to 6 months after surgery (p < 0.01 or p < 0.001); and (4) reduced pain from 1 day and 6 months after surgery (p < 0.001). ALT also has the advantage over AAT in reduced pain 5 days (p < 0.01) and 7 days (p < 0.05) after surgery and in decreased analgesic requirements during 14 days after surgery (p < 0.05). CONCLUSION: ALT is a sufficient and minimally invasive thoracotomy alternative to PLT or AAT for curative lung cancer resection.

Aged↗

PubMed1999

Effect of maitake (Grifola frondosa) water extract on inhibition of adipocyte conversion of C3H10T1/2B2C1 cells.

We investigated the effect of maitake (Grifola frondosa) water extract on inhibiting the conversion of C3H10T1/2B2C1 cells into adipocytes. Maitake water extract was fractionated by molecular sieve. Heat-labile compounds strongly inhibiting adipocyte conversion proved to occur in fractions of molecular weight of more than 10,000 on the basis of activity measurement of glycerol-3-phosphate dehydrogenase.

1-Methyl-3-isobutylxanthine↗

PubMed1999

[Bronchial dilatation due to broncholithiasis mimicking lung abscess].

A 61-year-old man who had been treated for pneumonia several times was examined because radiographs and computed tomograms disclosed a mass-like shadow associated with a cavity in the left lingular segment. The lesion was resected by video-assisted thoracoscopic surgery because it was suspected of being a lung abscess that had caused repeated episodes of inflammation. The resected specimen revealed a severely dilated peripheral bronchus due to broncholithiasis. It is often difficult to diagnose a lesion as broncholithiasis on the basis of secondary changes or calcification without bronchoscopic data. We emphasize that broncholithiasis should be suspected when a shadow resembling a lung abscess associated with symptoms of recurrent infection is found.

Bronchial Diseases↗