Biomedical subjects

H Horio

Publications and source records attributed to H Horio.

At least 55 records · Page 3Linked to original sources

PubMed1999

[Intrapulmonary hematoma surrounding the stapled line after video-assisted thoracoscopic bullectomy for spontaneous pneumothorax].

A 52-year-old man presented at our hospital with hemoptysis three months after undergoing a video-assisted thoracoscopic bullectomy for spontaneous pneumothorax. A chest X-ray showed a localized infiltrative shadow in the right upper lobe of the lung. The chest CT findings revealed a mass-like lesion surrounding the staple which had been used during the bullectomy. He therefore underwent a pulmonary resection including the lesion due to the continued hemoptysis that did not improve even after treatment by hemostatic agents and bronchial arterial embolization. The resected specimen revealed an intrapulmonary hematoma with severe inflammation. The late onset hematoma which was induced by the stapler may thus be a rare complication in video-assisted thoracoscopic surgery.

Endoscopy↗

PubMed1999

[Relationship between diabetes mellitus-associated obstructive sleep apnea syndrome and hyperinsulinemia].

The purpose of this study was to examine the prevalence of sleep disordered breathing and background factors, especially hyperinsulinemia, in diabetic patients. The subjects were 70 patients randomly selected from 143 noninsulin-dependent diabetic patients hospitalized for educational purposes. Obstructive sleep apnea syndrome (OSAS) was diagnosed in 13 subjects, equivalent to a prevalence of 18.6%. The mean +/- S.D. immunoreactive insulin (IRI) values for 11 of the 13 OSAS patients (excluding insulin-treated patients) and for 49 non-OSAS patients were 10.7 +/- 6.8 microU/ml and 5.8 +/- 3.5 microU/ml, respectively. The value for the OSAS group was higher than that for the non-OSAS group (p = 0.04). However, a positive correlation between body mass index (BMI) and IRI was observed in both the OSAS (Y = 1.148 X - 20.006, r = 0.834, p = 0.001) and non-OSAS (Y = 0.466 X - 5.820, r = 0.524, p = 0.0001) groups. Multivariate analysis demonstrated that the presence of OSAS had a statistically significant influence on IRI (p = 0.001), but not on BMI (p = 0.391). These findings suggest that hyperinsulinemia may be exacerbated in diabetic patients with OSAS regardless of BMI.

Body Mass Index↗

PubMed1999

[Clinical investigation of pulmonary tuberculomas diagnosed by video-assisted thoracoscopic biopsy].

We investigated the clinical characteristics of pulmonary tuberculomas and discussed strategies for their diagnosis. We compared a group of patients with lesions that had been diagnosed by bronchoscopy (the BF group: 15 patients, 17 lesions) with a group whose lesions had been diagnosed by thoracoscopy (the VATS group: 19 patients, 20 lesions). The VATS group included patients with lesions that could not be diagnosed by bronchoscopy alone. The 2 groups did not differ significantly in terms of patient age, gender, lesion size, number of bronchoscopic examinations, or tuberculin test findings. In both groups, the lesions always existed just below the pleural surface and were mostly located in the upper lobes of the lungs. Lesion locations in the middle lobe and lingular segment were observed only in the BF group, whereas locations in the lower lobes were observed only in the VATS group. Tuberculomas in 2 BF group patients (11%) and 10 VATS group patients (50%) were diagnosed on the basis of histopathologic findings in the absence of bacteriological evidence. No postoperative complications were observed in the VATS group, and all patients in this group were discharged from the hospital within 1 week. No relapse of tuberculosis was observed in either group following anti-tuberculous therapy. Video-assisted thoracoscopic biopsy is a reliable and minimally invasive diagnostic procedure, and should be performed on any solitary pulmonary lesion that cannot be diagnosed by bronchoscopy. It is important that tuberculomas be quickly and accurately diagnosed not only in order to distinguish them from lung cancer, but also to treat the patient's tuberculosis at an early stage and prevent it from spreading.

Adult↗

PubMed1998

[Video-assisted thoracoscopic surgery in spontaneous hemopneumothorax].

We retrospectively studied the safety and utility of video-assisted thoracoscopic surgery (VATS) in the treatment of spontaneous hemopneumothorax. Of 128 cases of spontaneous pneumothorax operated on our hospital from April 1988 to October 1997, hemopneumothorax developed in 8 cases (2 cases treated by thoracotomy and 6 by VATS). In all 8 cases, bleeding points and pulmonary bullae were easily found and hemostasis and resection of pulmonary bullae conducted quickly and safely. Two cases of VATS involved elective surgery. Of surgical emergent cases, the duration from visit our hospital to operation and surgical duration in VATS were almost as long as those in thoracotomy. The mean duration of postoperative chest drainage and postoperative hospital stay in VAST were less than in thoracotomy except for a VAST case with persistent air leakage. Blood loss from onset to operation and blood transfusion for VATS were almost equal to thoracotomy. Postoperative duration of analgesic use for VATS were shorter than that for thoracotomy. The VATS case with persistent air leakage should be necessary to reinforce the pulmonary stapled line or to convert to thoracotomy. In all cases, residual hematoma was found in the thoracic cavity. We conclude that early surgical repair should be performed once spontaneous hemopneumothorax is diagnosed and confirmed, and that VATS may be the first choice of surgery because it provides a better view and more facilitated manipulation during surgery than thoracotomy, and is a safe, nonaggressive therapeutic option.

Adult↗

PubMed1998

Serum surfactant protein A levels in healthy individuals are increased in smokers.

Serum levels of surfactant protein A (SP-A) were studied in 237 healthy subjects in relation to sex, age, and smoking habits. SP-A values in male smokers were significantly higher than those in male nonsmokers (p < 0.001). The amount of cigarette smoking did not correlate significantly with SP-A values, however. SP-A values in young nonsmoking males and females were somewhat lower than those in older, but without significant difference. No significant difference in values was found between the sexes. We conclude that (1) smoking increases serum levels of SP-A, and (2) SP-A serum levels are not affected by age and sex.

Adolescent↗

PubMed1998

Limited axillary thoracotomy vs video-assisted thoracoscopic surgery for spontaneous pneumothorax.

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has been reported to have a higher pneumothorax recurrence rate than limited axillary thoracotomy (LAT). We investigated the cause of pneumothorax recurrence after VATS by comparing surgical results for VATS and LAT. METHODS: Ninety-five patients with spontaneous pneumothorax underwent resection of pulmonary bullae by VATS (n = 51) or LAT (n = 44). Operating duration, bleeding during surgery, number of resected bullae, duration of postoperative chest tube drainage, postoperative hospital stay, postoperative complication, and pneumothorax recurrence were analyzed to compare VATS and LAT in a retrospective study. RESULTS: The duration of surgery, postoperative chest tube drainage, and postoperative hospital stay was significantly shorter in VATS than in LAT cases (p < 0.0005 and p < 0.005). Bleeding during surgery was significantly less in VATS than in LAT cases (p < 0.005). Numbers of resected bullae were significantly lower in VATS (2.7 +/- 2.1) than in LAT cases (3.9 +/- 2.7) (p < 0.05). Postoperative pneumothorax recurrence was more frequent in VATS (13.7%) than in LAT cases (6.8%), but there was no significant difference. CONCLUSIONS: VATS has many advantages over LAT in treating spontaneous pneumothorax, although the pneumothorax recurrence rate in VATS cases was double that in LAT cases. The lower number of resected bullae in VATS than in LAT cases suggests that overlooking bullae in operation could be responsible for the high recurrence rate in VATS cases. We recommend additional pleurodesis in VATS for spontaneous pneumothorax to prevent postoperative pneumothorax recurrence.

Adolescent↗

PubMed1998

Daily and long-term balloon dilation via minitracheostomy in cicatric bronchial stenosis.

We developed balloon dilation for bronchial stenosis via minitracheostomy. The balloon catheter was introduced via minitracheostomy into the stenotic bronchus. The balloon was inflated 4 hours per day. We conducted this procedure for a tuberculous cicatric stenosis of the left lower lobe bronchus. The bronchus was sufficiently dilated after eight applications. Compared with conventional balloon dilation via the mouth, the patient had less discomfort and could undergo treatment for a longer time and more frequently.

Adult↗

PubMed1998

A study on home health care support information system for health evaluation.

The need for home health care has been increasing in Japan and the application of various techniques such as medical informatics are desired to support home health care services. Therefore, we developed an information system for health evaluation of the elderly including patients at home by applying multifunctional telephone set and an IC memory card, by which complaints, symptoms, and conditions by them can be collected, recorded, and transmitted to medical facilities. We also conducted an experiment for trial use of the system with the cooperation of elderly female volunteers. It was recognized that the elderly volunteers could operate the system with the help of public health nurses and their health information could be collected by the system. Although the developed system has some problems, it was suggested that the system would be useful for the support of health evaluation of elderly at home.

Aged↗

PubMed1998

De-epithelialization for esophageal cyst by video-assisted thoracoscopic surgery monitored by esophagoscopy.

In a 26-year-old male a congenital esophageal cyst was de-epithelialized using electro-cauterization via video-assisted thoracoscopic surgery (VATS) together with esophagoscopy. As the cyst adhered firmly to the esophageal muscle layer and mucosa, partial excision of the cyst and burning up of the cystic mucosa by electro-cauterization was performed to prevent esophageal mucosal perforation and postoperative esophageal dysmotility. Intraoperative video esophagoscopic monitoring enabled esophageal mucosal perforation to be avoided. Postoperative barium esophagography revealed good esophageal motility, and the patient showed no symptoms of esophageal dysmotility. We conclude that de-epithelialization for congenital esophageal cysts using VATS together with esophagoscopy is a minimally damaging and reasonable curative procedure without postoperative complications.

Adult↗

PubMed1998

Lung adenocarcinomas diagnosed by open lung or thoracoscopic vs bronchoscopic biopsy.

STUDY OBJECTIVES: To examine the characteristics of peripheral lung adenocarcinomas diagnosed by open lung or video-assisted thoracoscopic surgery (VATS) biopsy. DESIGN: We used retrospective analysis to compare tumor stage, pleural involvement, central tumor fibrosis, and the number of bronchi or vessels involved with tumors of small peripheral lung adenocarcinomas diagnosed by bronchoscopic biopsy. PATIENTS: Subjects had lung adenocarcinomas diagnosed by open lung or VATS (n=22) and those diagnosed by bronchoscopic biopsy (n=22), which were matched by tumor size. RESULTS: The T1N0M0 tumor was notably more frequent in the open lung or VATS group (77.3%) than in the bronchoscopic biopsy group (36.4%) (p<0.01). Tumors invading beyond the pleural surface were less frequent in the open lung or VATS group (4.5%) than in the bronchoscopic biopsy group (40.9%) (p<0.01). The grade of in-tumor central fibrosis--a malignancy factor and the cause of bronchi or vessel involvement with tumors-was significantly lower in the open lung or VATS group than in the bronchoscopic biopsy group (p<0.01). The number of bronchi or vessels involved with tumors was significantly fewer in the open lung or VATS group than in the bronchoscopic biopsy group (p<0.001). CONCLUSIONS: (1) Lung adenocarcinomas diagnosed by open lung or VATS biopsy were more frequently T1N0M0 than those diagnosed by bronchoscopic biopsy, which was caused by low grade of central tumor fibrosis rather than small tumor size. (2) They were infrequently diagnosed by bronchoscopic biopsy because few bronchi were involved by tumors due to the low grade of central tumor fibrosis. (3) Small pulmonary nodules not diagnosable by bronchoscopic biopsy should be diagnosed aggressively using VATS biopsy to detect early-stage lung cancer.

Adenocarcinoma↗

PubMed1998

A study on development of a home health care support information system.

As the need for home health care has been increasing with the rising number of the elderly in Japan, the application of medical informatics to home health care delivery is considered to be useful. Therefore, development of a home health care support information system was planned. The system can collect patient's PHD (Personal Health Data) such as data of ECG, complaints, etc. at patient's home and can send the PHD to medical facilities. We designed and constructed two subsystems on a trial basis. One subsystem has function of gathering, recording and transmitting vital signs of the aged such as ECG, physical activity rate, oxygen saturation rate in arterial blood. Another subsystem can collect and send image data of the old people at their home. Experiments for trial use of the system was conducted and it was recognized that the PHD can be smoothly collected and recorded at home of the elderly and can be sent to the medical facilities with good success by using the system.

Aged↗

PubMed1998

[Usefulness of marking with colored collagen to localize small pulmonary nodules for thoracoscopic biopsy].

We examined the usefulness of marking with colored collagen to localize small pulmonary nodules (less than 10 mm in diameter) for thoracoscopy. Before using colored collagen, 2 of 6 lesions (33%) could be localized. It was possible to localize 14 of 15 lesions (93%) for thoracoscopy after marking with colored collagen, a percentage that is significantly higher than localization without such marking (P < 0.01). Thus, marking using colored collagen is useful to localize pulmonary nodules less than 10 mm in diameter for thoracoscopy.

Collagen↗

PubMed1998

[A case of pulmonary epithelioid hemangioendothelioma diagnosed by video-assisted thoracoscopic biopsy].

A regular annual physical checkup for a 46-year-old man revealed multiple small nodules, which were less than 1 cm in diameter, in both lungs. Metastatic lung tumors were suspected, but no primary lesion was found in the general examination. Video-assisted thoracoscopic surgery (VATS) diagnosed multiple pulmonary epithelioid hemangioendothelioma (PEH), so no treatment was performed. Careful follow-up showed no significant change during 10 months. VATS is thus a certain, noninvasive procedure for the diagnosis of PEH.

Biopsy↗

PubMed1998

[A 13-year-old male with a funnel chest treated by sternal elevation].

A 13-year-old male with a funnel chest was treated by sternal elevation method. Reconstruction was performed by resection of rib cartilage, wedge osteotomy of the anterior site of the sternum, sternal elevation by placement of a titanium A-0 plate under the sternum, and fixation of the wedge osteotomy site by a titanium plate. After surgery, the chest wall deformity was improved remarkably without complication. Although the A-0 plate was removed 19 months after surgery due to a break in the plate, cosmetic and functional results are now excellent 28 months after surgery.

Adolescent↗

PubMed1997

Serum Clara cell protein levels in lung cancer patients: an assessment of preoperative values and postoperative changes.

Serum levels of protein 1 (P1), a Clara cell protein known to have an antiinflammatory effect, were studied in 33 patients with lung cancer before surgery, and 3, 7, 14, 21 days, and 2 months after surgery. The preoperative P1 values of the lung cancer patients were compared with those of 66 healthy controls matched by sex and age. The postoperative changes in P1 which occurred in the lung cancer patients were compared with those in 16 patients who underwent laparotomy for gastric or colon cancer. There was no significant difference in the P1 values between the lung cancer patients and the healthy controls; however, the postoperative P1 values showed a significant decrease 3, 7, (P < 0.001), and 14 days (P < 0.05) postoperatively, recovering to normal within 2 months after surgery. One patient who died of postoperative pneumonia showed decreasing serum P1 levels until death. None of the laparotomy patients showed any decrease in P1 serum levels. Thus, we conclude that: (a) serum P1 levels do not differ between lung cancer patients and healthy individuals; (b) serum P1 levels significantly decrease in the early postoperative period, but recover within 2 months after lung resection; and (c) the postoperative changes that occur in serum P1 levels could provide important information about recovery from intraoperative lung damage.

Female↗

PubMed1997

Gelatin-resorcinol-formaldehyde-glutaraldehyde glue-spread stapler prevents air leakage from the lung.

BACKGROUND: To reinforce the staple line of the emphysematous lung and thereby prevent air leakage during thoracoscopic operations, we have developed a procedure of lung excision that uses a gelatin-resorcinol-formaldehyde-glutaraldehyde (GRFG) glue-spread stapler. METHODS: Formaldehyde-glutaraldehyde (FG) jelly is prepared by mixing FG fluid with 2.5% sodium carboxymethyl cellulose. The FG jelly is placed in the stapler groove and staple holes, and a gelatin-resorcinol (GR) mixture is applied. The GRFG glue-spread stapler was applied to emphysematous lung cutting during thoracoscopic operations in 10 cases. RESULTS: An adhesion-strength test showed no difference in glue adhesion between FG fluid and FG jelly. An experiment using swine lung showed that with this newly developed stapler, no resistance in firing occurred, and GRFG glue covered every staple hole. Clinical application in 10 cases with emphysematous lung demonstrated no air leakage from the staple line, even long after the operation. CONCLUSIONS: Emphysematous lung excision using the GRFG glue-spread stapler during thoracoscopic operations is useful in preventing air leakage from the staple line and is a simple, safe, and low-cost procedure.

Drug Combinations↗

PubMed1997

Contacting metastasis of a fibrous tumor of the pleura.

A 26-year-old female with a fibrous tumor of the pleura that metastasized to the other site of the pleura due to contact is reported. The primary lesion was a 6-cm pedunculated tumor originating from the diaphragm; the metastasis was a broad-based 1-cm tumor located on the parietal pleura of the lateral thoracic wall, within an area in contact with the primary tumor. The surrounding pleura around the small tumor and the diaphragm-the area that contacted the large tumor-was resected with both of the tumors under a thorascope. Despite a benign pathologic finding, a localized fibrous tumor of the pleura can then metastasize to the pleura due to contact. It was concluded that, because localized fibrous tumors of the pleura can occasionally metastasize to the area in contact with tumors, the intrathoracic cavity should be thoroughly observed using a thoracoscope.

Adult↗

PubMed1997

Chest wall reconstruction using a titanium hollow screw reconstruction plate.

A 43-year-old male had cancer of the right lung which had invaded the 2nd to 4th ribs. After right upper lobectomy and combined resection of the chest wall, the 3rd and 4th ribs were reconstructed using titanium hollow screw reconstruction plates (THORP). THORP completely prevented postoperative paradoxical respiration. The postoperative course was satisfactory. Postoperatively radiation therapy was performed, and the patient is now alive, without recurrence, 7 months after surgery. THORP is simple and eminently applicable in reconstructing the large chest wall.

Adult↗