Biomedical subjects

H Horio

Publications and source records attributed to H Horio.

At least 73 records · Page 4Linked to original sources

PubMed1997

Massive hemoptysis from an endobronchial metastasis of thyroid papillary carcinoma.

A 68-year-old female was admitted to our hospital with massive hemoptysis. She had undergone total thyroidectomy and postoperative radioisotope therapy for thyroid papillary carcinoma associated with multiple lung metastases one year before the present disorder. The right middle lobe was resected because of lethal airway bleeding from the lobe. Pathological examination showed an endobronchial metastasis 30 mm in size at the segmental bronchi. Other numerous small metastatic lesions exhibited two growth patterns: subepithelial endobronchial metastasis at the peripheral bronchi and visceral pleural metastasis. Endobronchial metastasis is an extreme type of lung metastasis of thyroid carcinoma, and can cause massive hemoptysis as the lesion increases in size.

Aged↗

PubMed1997

Non-serratus-sparing antero-axillary thoracotomy with disconnection of anterior rib cartilage. Improvement in postoperative pulmonary function and pain in comparison to posterolateral thoracotomy.

To examine the usefulness of non-serratus-sparing antero-axillary thoracotomy (AAT) with disconnection of anterior rib cartilage for curative resection of lung cancer, we used retrospective analysis to compare mortality, morbidity, hospital stay, time for thoracic opening, postoperative pulmonary function, and chest pain between AAT and posterolateral thoracotomy (PLT). Subjects were 50 lung cancer patients who underwent lobectomy via AAT (n = 25) or PLT (n = 25), who were matched by sex and age. Chest pain was evaluated using a visual analog scale, a McGill pain questionnaire, and analgesic requirements up to 6 months after surgery. AAT offered adequate exposure for lobectomy and mediastinal lymph node dissection. No difference was observed between the AAT and PLT groups in postoperative mortality, morbidity, or hospital stay. Times for thoracic opening were significantly shorter in AAT than in PLT (p < 0.001). FEV1 and vital capacity 1 week after surgery were significantly preserved in patients with AAT compared with patients with PLT (p < 0.05). Chest pain was significantly reduced in AAT patients compared with PLT patients on 1 day and from 14 days to 6 months after surgery (p < 0.01 to p < 0.001). We conclude that AAT is a reasonable thoracotomy alternative to standard PLT for curative lung cancer resection, because of its adequate exposure, shortened opening time, diminished impairment of postoperative pulmonary function, and reduced chronic postoperative pain.

Cartilage↗

PubMed1997

Opening of infectious giant bulla with use of video-assisted thoracoscopic surgery.

In 5 cases, an infectious giant bulla was opened with the use of video-assisted thoracoscopic surgery (VATS). Because all bullae adhered to the thoracic wall and were noncommunicating with the airway, they were opened without complete resection, leaving their inside walls at the lung and lateral walls on the thoracic wall. The expansion of remnant lung was excellent, and postoperative air leakage did not occur in any case. The postoperative vital capacity and FEV1 improved significantly over the preoperative condition (p<0.01). Because the bronchial communication of bulla is frequently obliterated after infection within the bulla, opening of a bulla is curative and simpler, more effective, and less invasive than complete resection.

Adult↗

PubMed1997

Descending necrotizing mediastinitis secondary to pharyngitis. A case report.

The patient was a 38-year-old female with descending necrotizing mediastinitis (DNM) originating from pharyngitis. The pus from infection by Bacteroides and aerobic streptococci had collected in the anterior and posterior mediastinum and bilateral thoracic cavity. Systemic antibiotic treatment with clindamycin and gentamycin was administered promptly after admission under a diagnosis of DNM, without waiting for results of culture and sensitivity studies. Four puncture drainages were performed by echoguide to treat bilateral empyema and left upper mediastinal pus collections. Additional surgical drainage via the transcervical approach was performed to drain right upper mediastinal pus. the patient was discharged on hospital day 50, and has since been in good health. Proper drainage at all pus collection sites by echo at both aerobic and anaerobic organisms are essential in the treatment of DNM.

Adult↗

PubMed1997

Long survival after extrapleural pneumonectomy for pleural malignant mesothelioma with metastasis to infradiaphragmatic lymph node.

A woman who at the age of 47 years underwent extrapleural pneumonectomy for malignant pleural mesothelioma with metastasis to an infradiaphragmatic lymph node is alive and well 63 months later. Because such metastasis is readily caused by lymphatic tumour-cell permeation from the diaphragm and parietal pleura, the infradiaphragmatic nodes should be dissected at extrapleural pneumonectomy for malignant pleural mesothelioma.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1997

[Analysis of small peripheral lung cancer diagnosed by open lung or thoracoscopic biopsy].

Twenty-six cases with lung cancer diagnosed by open-lung (n = 11) or thoracoscopic (n = 15) biopsy were analyzed. Mean tumor size was 19 mm. Biopsies were conducted due to the appearance of a nodular shadow determined by the retrospective X-p films in 13 cases, nodular shadow enlargement in 9, the positive suspicion of malignancy X-p findings without retrospective films in 3, and nodular shadow enlargement after medication of anti-tuberculosis drugs in one. Histology was adenocarcinoma in 18 cases, squamous cell carcinoma in 4, large cell carcinoma in 3, and adenosquamous cell carcinoma in one. The tumor stage was T1N0M0 in 14 cases, T1N0M0 in 3, T1N2M0 in 3, and unknown N factor because of lung wedge resection in 6 cases. Motality due to tumor recurrence was T1N2M0 in 3 cases and T1N1M0 in one. The remaining 22 cases survived without tumor recurrence. In short, small pulmonary nodules newly appearing or becoming with enlarged or found by retrospective X-p films should be conducted positively in thoracoscopic biopsy because of the high possibility of malignancy. Even if the tumor is small, lobectomy with lymph node dissection should be done, because of the very likely lymph node metastasis.

Adenocarcinoma↗

PubMed1997

[Cavernostomy, thoracoplasty and muscle plombage with the pedicled latissimus dorsi and serratus anterior flap for pulmonary aspergilloma].

A 49-year-old male with pulmonary aspergilloma secondary to pulmonary tuberculosis was admitted and treated by administration of itraconazole. However, as he continued to display fever and purulent sputum, we chose surgical treatment. We performed cavernostomy, thoraco plasty and muscle plombage with the pedicled latissimus dorsi and serratus anterior flap because pulmonary resection was seem to be life-threatening. The postoperative course was uneventful and satisfactory. We considered that this technique was safe and useful for the case of pulmonary aspergilloma which might be difficult to pulmonary resection.

Aspergillosis↗

PubMed1997

[Use of silicone stents for tracheobronchial stenosis due to tumors].

Six cases with tracheobronchial stenosis due to tumors were treated by Dumon stent (n = 3) or Dynamic stent (n = 3). Before placing the stent, the tracheobronchus was expanded by dilatation using a balloon or bougienage. The stents were placed successfully in all cases, and the symptoms of tracheobronchial stenosis disappeared. One case treated by Dumon stent and one case treated by Dynamic stent suffered from transient pneumonia after stent placement due to difficulty in sputum drainage, and one of these cases died of tracheal occlusion due to the sputum. In conclusion, for severe tracheobronchial stenosis due to tumors, dilatation by balloon or bougienage enables the stent to be placed more easily and safety. In cases with lowered capacity for sputum drainage, it is important to exercise care so as to ensure sufficient sputum drainage after placement of the stent.

Aged↗

PubMed1997

[A case of mediastinal ganglioneuroma in an elderly patient].

A 64-year-old woman was found to have a posterior mediastinal mass. X-ray findings revealed a neurogenic tumor, i.e., a schwannoma or neurofibroma. Postoperative pathological examination of the resected tumor showed it to be a ganglioneuroma an extremely rare occurrence, given the fact that the mediastinal ganglioneuroma tends to be diagnosed in adolescents and young adults.

Female↗

PubMed1997

[Analysis of small lung nodules diagnosed by open lung or thoracoscopic biopsy].

We examined clinicopathologic findings in 86 cases with peripheral lung nodules less than 30 mm in size diagnosed by open lung or video-assisted thoracoscopic surgery (VATS) biopsy. Biopsies were conducted because of the new appearance or enlargement of nodules as evidenced in a comparison with retrospective chest films in 47 patients, X-ray findings of malignancy suspicion without retrospective films in 13, enlargement of nodules after the administration of antituberculosis agents in 9, and a past history of malignancy in 17. Mean tumor size was 18.1 mm in primary lung cancer (n = 29), 16.2 mm in metastatic lung cancer (n = 13), 16.3 mm in tuberculosis (n = 18), 15.3 mm in nonspecific inflammation (n = 12), 16.7 mm in benign lung tumors (n = 7), 7.5 mm in intrapulmonary lymph node (n = 2), and 19.4 mm in others (n = 5). Among primary lung cancers with a clear N-factor, the percentage of T1N0M0 cancers was up to 72%. No significant difference was observed in either of the reasons for these biopsies and the size of nodules among diseases. To detect early lung cancer and increase the rate of cure, small pulmonary nodules that could be hardly diagnosed using bronchoscopic or needle aspiration biopsy should be diagnosed positively using VATS biopsy.

Adult↗

PubMed1997

[Long-term survival after multimodal therapy for lung cancer with pleural dissemination].

A 56-year-old man with peripheral T1N0M0 lung cancer underwent thoracotomy. Pleural dissemination was recognized intraoperatively. We performed wedge resection of the lung including the primary tumor, and applied hypotonic cisplatin treatment. We followed this up postoperatively with chemotherapy combined with cisplatin and irinotecan. One year later, a recurrent tumor occurred at the resected end of the lung, so we conducted stereotactic radiosurgery on the recurrent lung lesion, resulting in complete eradication. One year later, no relapse of cancer was observed. We conclude that implementing hypotonic cisplatin treatment in pleural dissemination of lung cancer followed by stereotactic radiosurgery on any recurrent tumor in the peripheral lung was effective for the present case.

Adenocarcinoma↗

PubMed1996

Retained sponge after thoracotomy that mimicked aspergilloma.

A 63-year-old man, who had had operation for the treatment of pulmonary tuberculosis 40 years before the present disorder, was admitted to our hospital with massive hemoptysis. Radiologic examinations showed a mass shadow with a crescent air sign resembling aspergilloma. Operative exploration showed a well-encapsulated retained surgical sponge between the middle and lower lobes. A bronchial fistula was present in the lower lobe. The appearance of the crescent air sign was caused by drainage of exudative effusion around the retained sponge. Intrathoracic retained surgical sponges associated with bronchial fistula should be included in the differential diagnosis of patients who have mass shadows with crescent air signs but no evidence of Aspergillus infection, and who have a history of thoracotomy.

Aspergillosis↗

PubMed1996

Colored collagen is a long-lasting point marker for small pulmonary nodules in thoracoscopic operations.

BACKGROUND: To locate small deep pulmonary nodules under thoracoscopy, we developed a long-lasting point marker termed "colored collagen." METHODS: Colored collagen is composed of 0.8% atelocollagen, 5% methylene blue, and 32% contrast medium. The affinity between atelocollagen and methylene blue was examined in a washing test using 2 mol/L of NaCl. For clinical application, a computed tomography-guided colored collagen injection was performed in 11 patients to localize 11 deep pulmonary nodules, which were less than 20 mm in diameter. RESULTS: The washing test showed that atelocollagen and methylene blue combined with each other firmly. An experimental study using rabbit lung showed that the colored collagen stayed at the injected site for 10 days without toxicity. In clinical application, the colored collagen could be seen as a clear spot using the thoracoscopy 1 to 4 days after the injection in all of the 11 pulmonary nodules. There was no complication except for a slight pneumothorax in 2 patients. CONCLUSIONS: The colored collagen, because it stays in the injected site for a long time, solves the problem of the single dye injection method, which requires both a computed tomographic scan and an operating room simultaneously, and also the colored collagen, because of its point dyeing, can mark the nodule more accurately than a single dye.

Adult↗

PubMed1996

Respiratory muscle strength after lung resection with special reference to age and procedures of thoracotomy.

Changes in respiratory muscle strength after lung resection were examined concerning age and procedures of thoracotomy. Maximum inspiratory (MIP) and expiratory (MEP) mouth pressure were measured before operation and 1, 2, 4, and 12 weeks after operation in 81 patients undergoing lung resection. In 48 patients undergoing pneumonectomy, lobectomy, or segmentectomy, patients older than 70 showed a significantly lower MIP and MEP before operation and throughout the postoperative period compared to younger ones (P < 0.01). Furthermore, the older patients showed a significantly lower percentage of postoperative MIP and MEP 4 weeks after operation than the younger ones (P < 0.01). In 31 patients undergoing lung wedge resection, patients undergoing limited thoracotomy (LT) and video-assisted thoracic surgery (VATS) showed significantly higher percentages of postoperative MIP and MEP than those undergoing posterolateral thoracotomy (PLT) 1 and 2 weeks after operation (P < 0.01 or 0.05). But there was no significant difference in the values between LT and VATS. We concluded that (1) elderly patients suffered respiratory muscle weakness before and after operation and their postoperative recovery of respiratory muscle strength was slower than in younger patients, and (2) VATS and LT resulted in more rapid recovery of respiratory muscle strength than PLT, but the difference between VATS and LT was not significant.

Adult↗

PubMed1996

Endofinger for tactile localization of pulmonary nodules during thoracoscopic resection.

To localize a deeply situated small pulmonary nodule during thoracoscopic resection, we developed as instrument a so-called "endofinger" for tactile localization of the nodule, and examined its usefulness. An attempt was made in 26 patients, using endofinger palpation under thoracoscopy, to localize twenty-six pulmonary nodules, each of which was less than 20 mm in diameter (mean 12.2 mm) and situated apart from the pleural surface. An endofinger comprises an extended "finger' section connected with a sleeve section. The sleeve section fits with a large contract area over the surgeon's forefinger, effectively lengthening it. The surgeon uses an endofinger in each hand and palpates a pulmonary nodule with the endofinger from two directions simultaneously. Surgeons could feel the hardness of nodules with a high degree of sensitivity. The sense of touch of the endofinger is much better than that of a simple bar, due to the large contact area of the sleeve section with the real finger. With the endofinger palpation 22 of 26 nodules were localized and their margins confirmed. All of 19 nodules larger than 10 mm in size had their locality confirmed by endofinger palpation. Four of 7 nodules smaller than 10 mm in size could not be localized, however. The endofinger is a useful instrument for tactile localization of pulmonary nodules under thoracoscopic surgery, especially for nodules larger than 10 mm. The method is simple, low-cost, time-saving, and has no complications.

Adult↗

PubMed1996

Clara cell protein correlation with hyperlipidemia.

Serum levels of protein 1 (P1), a Clara cell secretory protein, in 746 healthy subjects were measured and their correlations with different types of serum lipids and lipoproteins-that is, triglyceride (TG), total cholesterol (TCh), free cholesterol (FCh), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and apoproteins (apo) A-I, A-II, and B-were examined. P1 serum levels were examined for their correlation with body mass index (BMI), and were compared for 47 obese, 70 normal, and 17 lean males. P1 serum levels in 69 patients with diabetes mellitus and 24 patients with atherosclerotic stenosis of the carotid artery or coronary artery were also compared to those in healthy control subjects. P1 showed a significant positive correlation with TG, TCh, FCh, apo A-I, apo A-II, apo B, and BMI (r = 0.93, 0.26, 0.42, 0.11, 0.35, 0.58, and 0.20, respectively; p < 0.0001 to 0.05), and an inverse correlation with HDL (r = -0.32; p < 0.01). P1 values in obese men (mean +/- SD: 139.2 +/- 98.2 micrograms/L) were significantly higher than those in normal (90.3 +/- 57.1) and lean ones (65.6 +/- 40.8) (p < 0.01). In both diabetic and atherosclerotic patients, P1 serum levels did not significantly differ from those in healthy subjects. From these results, we conclude the following: (1) the serum levels of P1 correlate significantly with those of lipids and lipoproteins; (2) P1 serum levels increase in the case of obesity.

Arteriosclerosis↗

PubMed1996

[A case of dumbbell-shaped chondrosarcoma of the rib in the posterior mediastinum].

A 43-year-old man was pointed out an abnormal shadow in the left hilar lesion with no symptom. Chest CT and MRI showed that the mass might be a dumbbell-shaped neurogenic mediastinal tumor next to the 8th thoracic intervertebral foramen. The resection of the chest wall and the thoracic vertebrae including the tumor was carried out, so it was revealed chondrosarcoma arising from the 8th rib by the operative findings and histological examination. The dumbbell-shaped chondrosarcoma of the rib in the posterior mediastinum is very rare, and a brief review was made from the literature.

Adult↗

PubMed1996

[Modified trapdoor thoracotomy for lung cancer invading the distal border of the innominate vein].

A 62-year-old woman suffering from lung cancer of the left upper lobe has a tumor invaded the distal border of the left innominate vein. We resected the vein through trapdoor thoractomy combined with resection of the first rib, followed by a left upper lobectomy through posterolateral thoracotomy. Trapdoor thoracotomy combined with first rib resectioning thus proved useful to resect lung cancer invading the distal border of the innominate vein.

Brachiocephalic Veins↗