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Biomedical subjects

T Hirono

Publications and source records attributed to T Hirono.

At least 55 records · Page 3Linked to original sources
PubMed1990

[A case report of superior vena cava reconstruction using a heparin-coated temporary bypass tube].

A 56-year-old woman with stage IIIB (c-T1N3M0) small cell lung cancer was treated with combination chemotherapy (CAVE). After five cycles of chemotherapy a surgical resection was performed. As mediastinal lymph nodes (#2, 3, 3a) had invaded to the superior vena cava, a heparin-coated tube was inserted into the left innominate vein and the right auricular appendage as a temporary bypass. Advantages of a heparin-coated tube for the temporary SVC bypass are as follows. 1) simple operative procedure. 2) enough flexibility to be kept out of the operative field. 3) no need for anticoagulants, consequently less bleeding resulted.

Blood Vessel Prosthesis↗
PubMed1990

[Successful resection and reconstruction of the left atrium, right atrium and atrial septum under extracorporeal circulation in a patient with invasive pulmonary carcinoma].

A 69-year-old man was admitted to our hospital with a complaint of cough and hemoptysis. His chest X-ray showed an obstruction of the right intermediate bronchus and resultant atelectasis of the middle and lower lobes. Cytological examination by bronchoscopy showed squamous cell carcinoma. Although the cancer involvement of the left atrium could not be clearly defined by preoperative chest CT scan, the cancer invasion to the left atrial wall was recognized intraoperatively. Right pneumonectomy along with resection and patch reconstruction of the left atrium, right atrium and atrial septum was performed under extracorporeal circulation. Postoperative hemodynamic state was stable, and echocardiography showed normal volume of the left atrium. Histological examination of the resected specimen showed moderately differentiated squamous cell carcinoma with the involvement of the left and right atrial wall. The resected margins of the left and right atria were free of malignancy. Although he had been clinically in good condition and free from any sign of cancer recurrence, he died of aspiration pneumonia five months after the surgery.

Aged↗
PubMed1990

[Significance of fiberoptic bronchoscopy after pulmonary resection of lung cancer for early detection in second lung cancer].

By the end of 1988, seventy five cases after pulmonary resection for lung cancer and one case after pulmonary resection for basal cell hyperplasia were examined with fiberoptic bronchoscopy as postoperative follow up. Endobronchial tumor was detected in 14 cases. In seven cases, endobronchial tumor was located at site far from the surgical bronchial anastomosis. These tumors were suspected as second lung cancer as long as examined by fiberoptic bronchoscopy. Histological type of all of these was squamous cell carcinoma. Re-operations were performed in five cases and two of them were early lung cancer. In 6 cases (13.6%) among 44 cases examined with fiberoptic bronchoscopy after pulmonary resection for central type squamous cell carcinoma, second lung cancer was detected. In the case of central type squamous cell carcinoma, usually the tumor appears to be of same histological type and at same location. Among those cases those who smoke heavily should be separated as high risk group. If this group is followed with fiberoptic bronchoscopy or sputum cytological examination, it is more possible to detect second lung cancer at an early stage.

Bronchoscopy↗
PubMed1989

[Postpneumonectomy esophagopleural fistula--successful one-stage repair with omental flap and thoracoplasty].

A 69 year-old man, who had undergone left pneumonectomy for squamous cell carcinoma of the lung 21 months ago, was admitted with a high temperature and chest pain. A diagnosis of empyema was made, and a chest tube was inserted for drainage. Bronchopleural fistula was not noted. Noticing that food was leaking through the drainage tube, a diagnosis of esophagopleural fistula was made radiologically. Surgery was done in October, 1987, after irrigating an empyema space for two months. The fistula was approximately 4 cm below the carina, and it was closed directly. The omentum was sutured around the closed site to reinforce and obliterate the empyema space. Furthermore, additional thoracoplasty was done because the cavity was too large to close only with the omentum. The postoperative course was uneventful. He was able to eat specially prepared foods within 4 weeks, and was discharged on the 60th day after the operation. This patient could possibly be the first case who had undergone an omental flap for the closure of a postpneumonectomy esophagopleural fistula.

Aged↗
PubMed1989

[Pulmonary complication after resection of lung cancer--difficulty in expectoration and cough dynamics].

From January 1975 to December 1986, 415 patients were operated for primary lung cancer. Postoperative pulmonary complications were observed in 83 patients and among them 48 patients (57.8%) suffered from difficulty in expectoration. Postoperative expectoration mostly depends on the ability of coughing. To evaluate cough dynamics, expiratory flow-rate and volume at voluntary maximal cough were measured. The more expiratory flow rate and volume a cough has, the more effective it is for expectoration. In those patients with decreased FEV1.0, or respiratory muscle weakness because of emaciation and aging, or severe pain in the wound, the cough dynamics was decreased. By cleaning retained secretions in the respiratory tract, postoperative pulmonary complications would be prevented. However in cases where the decrease in postoperative cough dynamics is predictable, application of limited resection should be considered as well.

Aged↗
PubMed1989

[A case of congenital diaphragmatic hernia due to left central tendon defect in pregnancy].

A twenty-seven-year-old 25 weeks gestation female was admitted with recurrent symptoms of nausea, vomiting and epigastric pain. She was diagnosed as left diaphragmatic hernia by chest X-ray film, CT and esophago-gastrography. During operation, a left central tendon defect was observed, and was 3.5 cm in diameter. The margin of the defect was smooth and round. It was associated with diaphragmatic eventration. The small intestine and transverse colon were herniated into the left thoracic cavity. The central tendon defect was closed with direct mattress sutures and was reinforced by overlap-technique of the diaphragm. To our knowledge, this type of defect has not been described previously in Japan. Diaphragmatic hernia in pregnancy is very rare, and presents abdominal pain, vomiting and dyspnea. Usually the diagnosis is achieved by chest X-ray film. However, esophago-gastrography should be added, if the diagnosis could not be confirmed by chest X-ray film. Conservative management is reported to bring high mortality, therefore, prompt surgical repair is advisable.

Adult↗
PubMed1988

Recognition of artificial microstructures by sensory nerve fibers in culture.

Dissociated culture of adult mouse dorsal root ganglion cells on glass plates, on which grating-associated microstructures (a repetition of microgrooves [mGRV] and microsteps [mSTP] of 0.1-10 micron) are fabricated by the conventional lithographic techniques, represents a remarkable bi-directional growth of their nerve fibers in the axial direction of the grating. Microscopical observation shows that the nerve fibers prefer to grow in the mGRV (70%), while their growth cones exhibit an even distribution onto the mGRV and mSTP. The efficiency of the nerve fibers to grow along the grating-axis are highly sensitive to a fine alteration of the width and depth of the mGRV. The preferential growth of the nerve fibers is thus due to a mechanical recognition of the microstructures by the growth cones and neurites.

Animals↗