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Biomedical subjects

H Horigome

Publications and source records attributed to H Horigome.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Right atrial hemangiopericytoma with hemopericardium during infancy.

A male infant with benign hemangiopericytoma of the right atrium is reported. His chief complaint was acute respiratory distress secondary to bloody pericardial effusion. Although the entire mass could not be removed surgically, there was no recurrence of cardiac tamponade or growth of the residual mass during a follow-up period of 3 years. This patient is, to our knowledge, the youngest one with primary cardiac hemangiopericytoma so far reported.

Echocardiography↗
PubMedDate not supplied

Absent pulmonary valve with intact ventricular septum presenting as cardiorespiratory failure at birth.

Absent pulmonary valve with intact ventricular septum is a rare congenital anomaly. Most cases are not diagnosed until years after birth, although several cases have been reported in the literature in which cardiorespiratory distress developed during the neonatal period. We present a patient who showed improvement after fairly conservative therapy to alleviate the pulmonary vascular resistance, with ultimate palliative surgery. The aneurysmal dilatation of the pulmonary artery was for the most part confined to the proximal portion of the trunk, possibly because the ductus arteriosus was patent. The literature is reviewed.

Cardiac Output, Low↗
PubMedDate not supplied

Right coronary artery to left ventricular fistula associated with left ventricular aneurysm.

An infant with right coronary artery to left ventricular fistula associated with left ventricular aneurysm successfully underwent a division of fistula under cardiopulmonary bypass. Follow-up angiogram showed the patency of the right coronary artery, no recurrence of fistula, and the regression of the left ventricular aneurysm. Because the lesion may progress with age, early diagnosis and surgical intervention are indicated to prevent later complications.

Aneurysm↗
PubMedDate not supplied

Percutaneous radio-frequency ablation therapy using a clustered electrode for malignant liver tumors.

GOALS: To examine the safety and effectiveness of percutaneous radio-frequency ablation therapy (PRAT) for malignant liver tumors, using a needle with cluster radio-frequency (RF) electrodes. STUDY: The subjects were 13 patients with solitary malignant liver tumors: 10 had hepatocellular carcinoma and 3 had metastatic liver tumors. One session of PRAT with cluster RF electrodes was performed until roll-off occurred two times. Dynamic computed tomography (CT) and fine needle tumor biopsy under ultrasonographic guidance were conducted to assess the therapeutic efficacy. Aspartate aminotransferase, alanine aminotransferase, lactic dehydrogenase, and total bilirubin were evaluated before and 1, 3, and 7 days after PRAT. RESULTS: There were no serious complications. Aspartate aminotransferase, alanine aminotransferase, and lactic dehydrogenase levels peaked 1 day after PRAT and decreased thereafter. No icterus occurred. Of the 13 tumors, 12 showed complete necrosis on dynamic CT; however, one of them showed histologically incomplete necrosis in the tumor biopsy. In both of the ineffective cases, the tumors were located near relatively large vessels. There was no recurrence in the liver in all cases of PRAT that were effective (observation periods: 6--14 months; mean, 10 months). CONCLUSIONS: Percutaneous radio-frequency ablation therapy using a clustered electrode is a safe and effective treatment of malignant liver tumors, if the tumor is not located near the large vessels.

Aged↗
PubMedDate not supplied

Large placental chorioangiomas as a cause of cardiac failure in two fetuses.

We report 2 cases of fetal heart failure associated with large placental chorioangiomas. One fetus exhibited serious hydrops on the initial fetal echocardiogram and was ultimately stillborn. The fetus in the other case exhibited cardiomegaly. Following the premature termination of the pregnancy, the fetus received medical treatment and recovered in 7 days. Monitoring the fetal cardiac size with ultrasonography is recommended to determine the optimal time of delivery in cases of large placental angioma that are diagnosed prenatally.

Abortion, Spontaneous↗
PubMedDate not supplied

Endoscopic injection sclerotherapy for esophagogastric variceal bleeding in children with biliary atresia.

BACKGROUND/AIMS: To determine the safety and effectiveness of endoscopic injection sclerotherapy (EIS) for children with biliary atresia. METHODOLOGY: Subjects were 7 patients with biliary atresia with esophagogastric varices and variceal bleeding. Intravariceal injection using 5% ethanolamine oleate was performed under fluoroscopy until varices were eradicated. RESULTS: Endoscopic examination revealed that bleeding occurred in the junctional gastric varices in most of the cases. The mean number of EIS sessions required for obliteration of the varices was 2.3. In the observation period (mean: 21 months), recurrent esophagogastric varices occurred in 2 patients. One had variceal bleeding that was treated successfully by additional EIS. There were no severe complications associated with EIS. CONCLUSIONS: EIS under fluoroscopy was safe and effective for variceal bleeding in children with biliary atresia.

Adolescent↗
PubMedDate not supplied

Coexistence of primary biliary cirrhosis and myasthenia gravis: a case study.

We present a case that suggests a relationship between primary biliary cirrhosis and myasthenia gravis. A 43-year-old Japanese woman was admitted to the Nagoya City University Medical School, First Department of Internal Medicine with abnormal liver function in August 1991. She had had ptosis of the right eye since 1990. She had not been treated for liver disease. Ptosis of the right eye and hepatomegaly were present. Serum laboratory examinations revealed elevated biliary enzymes and IgM levels; tests were positive for antimitochondrial antibody and antiacetylcholine antibody. Liver histology revealed chronic non-suppurative destructive cholangitis and led to a diagnosis of primary biliary cirrhosis. The tensilon test was positive. Electromyography with repetitive motor nerve stimulation revealed a neuromuscular junction defect; i.e., the primary characteristic of myasthenia gravis. The patient was diagnosed with myasthenia gravis. Although the development of myasthenia gravis has previously been reported in patients with primary biliary cirrhosis during D-penicillamine administration, this is a very rare case of the coexistence of both diseases before such treatment.

Adult↗
PubMedDate not supplied

Treatment of solitary small hepatocellular carcinoma: consideration of hepatic functional reserve and mode of recurrence.

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) recurs frequently after initial treatment. The subsequent prognosis varies with the mode of recurrence. Some patients die of hepatic failure even though the HCC is controlled. We consider the clinical stage (CS), using the modified Child-Pugh classification, to be an important factor influencing the prognosis of these patients. METHODOLOGY: To determine the most effective treatment for HCC, we examined 105 patients with solitary small HCC who were followed-up for more than 1 year after initial treatment. All of them were judged to be cured according to imaging or histological studies. The initial treatments were hepatic resection (n = 43), percutaneous ethanol injection therapy (PEIT, n = 33), and percutaneous microwave coagulation therapy (PMCT, n = 29). The modes of recurrence were divided into intrahepatic metastasis (IM) and multicentric occurrence (MO). RESULTS: Prognosis of MO was superior to that of IM in CS I patients, but there was no difference in prognosis between these modes in CS II. The hepatic resection group had more MO recurrences in CS I patients and more IM recurrences in CS II patients. IM developed frequently after PEIT and PMCT, regardless of the CS. Prognosis with hepatic resection was superior to that of the other treatments in CS I patients, but there was no difference in prognosis among the 3 treatment modalities in CS II patients. CONCLUSIONS: These data indicate that hepatic resection is the first choice for treating HCC in CS I patients, and that PEIT or PMCT is preferable for CS II patients.

Aged↗
PubMedDate not supplied

Diagnosis of small hepatocellular carcinoma--imaging diagnosis and significance of tumor biopsy.

BACKGROUND/AIMS: To compare the effectiveness of different imaging modalities and the significance of tumor biopsy for diagnosing small hepatocellular carcinoma. METHODOLOGY: Nodules (n = 352) with diameters of 30 mm or less newly detected by periodic ultrasonography and computed tomography in 234 patients with chronic liver disease were investigated with magnetic resonance imaging and digital subtraction angiography. These findings were compared with histologic findings. Histologic diagnoses were dysplastic nodule (n = 23), well-differentiated hepatocellular carcinoma (n = 163), moderately differentiated hepatocellular carcinoma (n = 159), and poorly differentiated hepatocellular carcinoma (n = 7). We compared three groups based on-diameters of 10, 11-20, and 21-30 mm. Nodules were diagnosed as hepatocellular carcinoma if they had hypervascular staining on digital subtraction angiography, hyperintensity on magnetic resonance T2-weighted images, arterial phase enhancement on enhanced magnetic resonance imaging, or low-high-low density on enhanced computed tomography. RESULTS: Imaging alone was sufficient to diagnose hepatocellular carcinoma in 66.3% of the well-differentiated nodules and 91.6% of the moderately and poorly differentiated nodules (P < 0.001) The size of the nodule influenced the diagnosis of hepatocellular carcinoma by imaging alone in 65.5% (< or = 10 mm), 77.2% (11-20 mm), and 92.3% (21-30 mm) (< or = 10 vs. 21-30: P < 0.0001, 11-20 vs. 21-30: P < 0.0005). It was impossible to determine the degree of differentiation of the hepatocellular carcinoma by imaging alone. CONCLUSIONS: The effectiveness of imaging for the diagnosis of hepatocellular carcinoma improved with decreasing differentiation and increasing diameter of the nodules. Tumor biopsy was required to make a histological accurate diagnosis.

Angiography, Digital Subtraction↗
PubMedDate not supplied

Percutaneous radiofrequency ablation therapy using a clustered electrode in the animal liver.

BACKGROUND/AIMS: The aim of the present study was to examine the safety and effectiveness of percutaneous radiofrequency ablation therapy using a needle with cluster radiofrequency electrodes in an animal model. METHODOLOGY: A total of 10 radiofrequency applications were performed in the normal liver of 5 domestic pigs with real-time ultrasonography until roll-off occurred two times. Aspartate aminotransferase, alanine aminotransferase, lactic dehydrogenase, and total bilirubin were evaluated before the procedure and 1 h, 24 h, and 7 days following percutaneous radiofrequency ablation therapy. The animals were euthanized 1 or 2 weeks after percutaneous radiofrequency ablation therapy, and the livers were removed for gross and histopathologic analysis for coagulation necrosis. RESULTS: There were no complications in any of the experimental animals. Aspartate aminotransferase, alanine aminotransferase, and lactic dehydrogenase levels peaked 24 h following percutaneous radiofrequency ablation therapy, and decreased with time thereafter. Total bilirubin was not elevated in any of the animals at any time. Macroscopic examination revealed that the area of coagulated necrosis was 28 x 21 mm when using a 2.0-cm needle, and 41 x 35 mm when using a 3.5-cm needle. Coagulation necrosis did not occur near large vessels. Microscopic examination of the fixed tissue revealed that coagulation necrosis occurred in preserving lobular structure. CONCLUSIONS: Percutaneous radiofrequency ablation therapy using a clustered electrode is a safe and effective treatment for liver tumor. Incomplete coagulation necrosis, however, can occur when percutaneous radiofrequency ablation therapy is performed for tumors located near large vessels.

Alanine Transaminase↗