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Biomedical subjects

H Horigome

Publications and source records attributed to H Horigome.

At least 55 records · Page 3Linked to original sources
PubMed1996

Left ventricular functions are not impaired after lumbar epidural anaesthesia in young children.

We studied the haemodynamic and cardiovascular effects of epidural anaesthesia with plain bupivacaine 0.75 ml.kg-1 in 13 unpremedicated ASA 1 children using measurements of heart rate, blood pressure and M-mode echocardiography. Under general anaesthesia, M-mode echocardiographic evaluation of left ventricular function in each patient was performed at four points (after general anaesthesia, point A; 5 min, 10 min and 25 min after epidural anaesthesia, point B; point C; and point D, respectively). Results were compared between point A and B, A and C, A and D, B and C, B and D, C and D. HR decreased significantly at 10 min (point C) and 25 min (point D) and MBP decreased at 5 min (point B) and 10 min (point D) compared to point A. No other M-mode cardiographic indices were changed at any point. Epidural anaesthesia using 0.25% bupivacaine 0.75 ml.kg-1 did not affect LV function in young children.

Anesthesia, Epidural↗
PubMed1996

[Anomalous origin of the left coronary artery from the pulmonary trunk with myocardial infarction and severe left ventricular dysfunction in infancy--assessment of myocardial damage using SPECT studies with 201TlCl and 123I-BMIPP].

A 4-month-old male infant with Bland-White-Garland (BWG) syndrome complicated myocardial infarction was reported. Signs included tachypnea, coughing, and failure to thrive. However, there was no sign of myocardial infarction. A chest radiograph revealed cardiomegaly (CTR = 65%) and electrocardiogram showed abnormal Q waves in I, aVL, V6 leads. Cardiac catheterization and angiography revealed marked dilatation of left ventricle (end-diastolic volume = 384 ml/m2) and extremely depressed ejection fraction (16%), confirming the diagnosis of BWG syndrome. A 201TlCl-myocardial SPECT demonstrated apical defect and hypoperfusion in the anterolateral, inferoposterior walls, whereas 123I-beta-methyl-p-iodophenylpentadecanoic-acid (123I-BMIPP) SPECT showed a wider defect area. SPECT studies with 201TlCl and 123I-BMIPP, are useful to assess myocardial viability more accurately in BWG syndrome.

Coronary Vessel Anomalies↗
PubMed1995

Sinus node recovery function is relatively well preserved under halothane anaesthesia in children.

The purpose of this study was to evaluate the effect of halothane on sinus node recovery time (SNRT). Nine children with congenital heart disease scheduled for cardiac catherization were studied. After the routine procedure, the sinus node was paced at rates of 120, 150 and 180 beats per minute. SNRTs were measured with control conditions and under 1 MAC halothane anaesthesia. The absolute SNRT was standardized and expressed as '%SNRT' and 'Corrected SNRT (CSNRT)'. CSNRT was slightly prolonged by halothane (P = 0.042), while the %SNRT was not significantly prolonged. We conclude that the recovery function of the sinus node is relatively well preserved under 1 MAC halothane in children.

Anesthesia, Inhalation↗
PubMed1995

[Postoperative bronchial stenosis associated with IAA complex and transendoscopic resection of intrabronchial granulation].

Problem with stenosis of the left bronchus was encountered in a patient with type B interrupted aortic arch complex after the arch reconstruction and pulmonary artery banding. Bronchoscopic study disclosed the intraluminal granulation of left bronchus and transendoscopic resection of the granulation successfully relieved the stenosis and brought the patient to full recovery.

Airway Obstruction↗
PubMed1993

Echocardiographic evaluation of vagolytic effects of atropine sulfate during pediatric halothane anesthesia.

The aims of this study were to define the antagonistic effects of atropine sulfate to halothane-induced cardiovascular depression in children, and to clarify whether or not a larger dose of atropine is more effective in attenuating the cardiovascular depression. Thirty-four children aged 1-12 years who had undergone minor surgery, free from cardiac or pulmonary disease, were assigned at random to two groups. M-mode echocardiographic evaluation of left ventricular function in each patient was performed at three points (before induction, point A; after induction, point B; and following administration of atropine, point C). Results were compared between points A and B, B and C and C and A, and between the two study groups with different doses of atropine (0.01 mg/kg vs 0.02 mg/kg). Heart rate (HR), mean blood pressure (MBP) and left ventricular shortening fraction (LVSF) decreased, and left ventricular end-diastolic dimension (LVEDD) were increased significantly by halothane induction. Although HR and MBP recovered following atropine, LVSF and LVEDD remained unchanged. There were no differences found between the values after vagolysis in both study groups, except for HR and mean velocity of circumferential fiber shortening (mVcf). Heart rate increased above that of pre-induction, even following the smaller dose of atropine. The myocardial depression cannot be necessarily attenuated by vagolysis regardless of the dosage of atropine. The smaller dose (i.e. 0.01 mg/kg) seems to be sufficient only to antagonize the bradycardia and hypotension during halothane anesthesia in children.

Adolescent↗
PubMed1992

[Surgical managements of the compression of trachea and/or bronchus associated with congenital cardiovascular anomalies].

From 1987 through 1990, 17 cases with tracheal and/or bronchial compression due to congenital cardiovascular malformations were experienced at our institutes. Respirator was required preoperatively in 10 patients (59%) due to severe respiratory symptoms by airway compression and narrowing. In all cases, bronchoscopy was carried out pre- or intra-operatively for the precise diagnosis and for the decision of operative procedures. Postoperatively 12 cases were successfully extubated and remained free of respiratory distress. We investigated the relationships among pre- and post-operative pressure ratio, preoperative flow ratio, requirement of preoperative respirator and indication for plication and suspension of pulmonary artery in the group of the patients, who had airway compression by the dilated pulmonary artery due to large left to right shunt. As a result of this investigation, these factors have no significant correlation. The severity of associated tracheomalacia might be a most susceptible cause, which required the preoperative managements with respirator and the surgical interventions to the dilated pulmonary artery. Infant with patent ductus arteriosus (PDA) could be surgically treated by the division of PDA through left lateral thoracotomy. If the left main bronchus shows complete obstruction after division of PDA, the additional surgical intervention like suspension of aortic arch is needed. Two cases were lost with reoperation and these suggested not only the priority of simultaneous repair of trachea and cardiovascular anomaly, but the necessity of minor intervention against adhesion (insertion of Gore-Tex sheet between suspended pulmonary artery and sternum) in the first-step palliative operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1991

Plasma vasopressin response to contrast medium during cardiac catheterization in infants and children.

Fifteen infants and children (M = 7, F = 8), aged from 0 to 13 years, who underwent cardiac catheterization and cardioangiography under ketamine-diazepam anesthesia were the subjects of this study. The effect of a contrast medium, isolamate sodium (66.8%) on the plasma somolality and vasopressin concentration was studied. The plasma osmolality was significantly elevated after contrast medium administration (289 +/- 3 vs. 303 +/- 8 mosmol.kg(-1)) as well as plasma vasopressin (from 2.1 +/- 0.9 vs. 4.7 +/- 2.0 micro-unit.ml(-1)). It is concluded that the administration of contrast medium for cardioangiography causes elevation of plasma osmolality, which leads to the elevation of plasma vasopressin concentration.

Journal Article↗
PubMed1990

Sudden fatal cardiac arrest in a child with an unrecognized anterior mediastinal mass.

We report a case of sudden fatal cardiac arrest in a 3-year-old boy. The arrest occurred when he was placed in the supine position by force for a venipuncture. Autopsy revealed a large anterior mediastinal mass. The death was attributed to the airway obstruction and cardiac compression by the mass. Postural change to supine position by force was believed to have triggered compression of the cardiopulmonary system by an unrecognized anterior mediastinal mass, resulting in cardiac arrest.

Child, Preschool↗
PubMed1989

Oesophageal lung with systemic arterial blood supply.

An adolescent girl with congenital bronchopulmonary-foregut malformation (BPFM) is reported. The patient had a hypoplastic, non-functioning right lung with the main bronchus originating from the oesophagus. The pulmonary artery of the "oesophageal lung" was supplied by systemic circulation from the descending aorta, and the venous flow drained through a hypoplastic right pulmonary artery (RPA) into the large left pulmonary artery (LPA). This case was a rare type of left-to-right shunt and demonstrates that oesophagography, pulmonary angiography and aortography are important in demonstrating the haemodynamics involving this malformation.

Adolescent↗
PubMed1989

Echocardiographic evaluation of vagolytic effects of hyoscine butylbromide in paediatric halothane anaesthesia.

The effects of vagolysis with hyoscine butylbromide on left ventricular function were evaluated by echocardiography during halothane anaesthesia in children. Echocardiography showed deterioration of the following values after halothane induction; pre-ejection period, systolic time interval, left ventricular shortening fraction and ejection fraction. The first two values were improved by vagolysls with hyoscine butylbromide. However, relatively rate-independent indices, i.e. left ventricular shortening fraction and ejection fraction, still remained depressed even after vagolysis with hyoscine butylbromide. This implies that halothane-induced myocardial depression can only be partially antagonized by vagolysis.

Anesthesia, Inhalation↗
PubMed1989

[A case of effusive-constrictive epicarditis found by electrocardiogram at a school health examination].

An effusive-constrictive pericarditis confined to the epicardium is extremely rare in childhood. We report case of a 7-year-old boy with such a condition. During an annual school health examination, he was found to have low voltage activities on electrocardiogram. On admission, physical examination showed markedly distended abdomen due to ascites and hepatomegaly. Two-dimensional echocardiography revealed small ventricular cavities, extremely dilated inferior vena-cava, and a moderate amount of pericardial fluids. Pericardial and epicardial thickening were also suspected. Retrospectively, epicardial thickening was suspected on computed tomogram as well. Cardiac catheterization showed a typical diastolic dip and plateau pattern on the right ventricular pressure tracing, and deep x and y descents on that of the right atrium, suggesting that not pericardial effusion, but pericardial thickening mainly contributed to the cardiac dysfunction. Pericardiocentesis did not improve the clinical symptoms and high central venous pressure. On thoracotomy, we unexpectedly found intact pericardium and fibrotic epicardium covering the whole heart, so epicardiectomy was performed. Despite the fact that most of the fibrotic epicardium was removed, there were no immediate responses such as decrease in central venous pressure within the first 5 days after the surgery. Furthermore, it was not until two months later that all symptoms and hemodynamic parameters returned to normal levels. There have been several case reports of isolated epicardial constriction associated with pericardial effusion in English literature. However, we are unaware of such a report n Japanese. We concluded that it is important to evaluate the hemodynamics before and after pericardiocentesis, and to detect peri-and/or epicardial thickening by serial echocardiography and CT scan.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗