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Biomedical subjects

O Hirose

Publications and source records attributed to O Hirose.

At least 37 records · Page 2Linked to original sources
PubMed1984

High-dose intravenous gammaglobulin for Kawasaki disease.

The ability of high-dose intravenous gammaglobulin (IVGG) to prevent the coronary artery lesion of Kawasaki disease has been studied in a multicentre controlled trial of IVGG plus aspirin versus aspirin alone, aspirin being the conventional treatment for Kawasaki disease. Patients were allocated at random to aspirin (45 cases) or IVGG (40 cases), there being no significant intergroup differences in age, sex ratio, duration of disease until the start of treatment, or severity. The development of coronary artery dilatation was monitored by two-dimensional echocardiography. Within 29 days of the onset of the disease, this lesion had developed in 19 cases (42%) in the aspirin group and in 6 cases (15%) in the IVGG group. There were no new instances of this lesion: in the period 30-60 days coronary artery dilatation persisted in 14 and 3 cases, respectively. In patients found to have echocardiographic abnormalities selective coronary arteriography was done 30-60 days after onset of Kawasaki disease and the lesion was confirmed in 1 of the 6 cases in the IVGG group and in 11 of the 19 controls. High-dose IVGG seems to reduce the frequency of coronary artery abnormalities in patients with Kawasaki disease.

Acute Disease↗
PubMed1984

[Clinical application of two-dimensional echocardiography in fetal cardiac arrhythmias].

Fetal echocardiography was performed in 16 patients referred for the evaluation of cardiac arrhythmias at 29 to 39 weeks' gestation and in 5 normal fetuses for the control. In all fetuses, the heart could be visualized by two-dimensional echocardiography. Monitoring the four-chamber view by two-dimensional echocardiography, we examined recorded the contraction sequence of the atrial and ventricular walls and the ventricular septum by single or dual M-mode echocardiograms, and could diagnose various arrhythmias including atrial flutter, complete and incomplete heart blocks, premature contractions and sinus arrhythmias. These arrhythmias frequently accompanied with heart failure, which was evaluated fairly well by total cardiac dimensions echocardiographically determined. Ascites, pleural effusion, pericardial effusion and skin edema were mostly observed in severe congestive heart failure.

Arrhythmias, Cardiac↗
PubMed1982

A trial procedure to prevent aneurysm formation of the coronary arteries by steroid pulse therapy in Kawasaki disease.

Sixty patients with Kawasaki disease in the acute phase were studied using a two-dimensional echocardiography. Coronary lesions in Kawasaki disease were characterized echocardiographically by an increase of echo density of the coronary artery and by dilatation or aneurysm of the coronary artery. These findings appeared in the sequence mentioned above in patients who were studied serially. In the group treated with corticosteroid, 62% of the patients showed a disappearance or an improvement of the coronary dilatation or aneurysm, while only 33% of untreated patients showed such an improvement. In patients with coronary aneurysms on the initial echocardiogram, 53% of the pulse therapy group showed an improvement, but none of the untreated group did. A similar result was obtained by an analysis of its therapeutical effect, according to the number of vessels involved. Thus, corticosteroid pulse therapy was shown to be effective for the prevention of coronary arterial aneurysms in Kawasaki disease, if it was given in a sufficient dose in the acute phase of this disease.

Adrenal Cortex Hormones↗
PubMed1982

[Clinical study of membranous ventricular septal defect in infancy and childhood by two-dimensional echocardiography].

A two-dimensional echocardiographic study was performed in patients (pts) with isolated ventricular septal defect (VSD). Group I included 48 pts with membranous VSD (aged from 3 months to 11 years) diagnosed by cardiac catheterization and angiocardiography. In 25 of 27 pts demonstrated a defect only by two-dimensional echocardiography (2DE), mean pulmonary artery pressure (MPAP) was higher than 25 mmHg and 26 of these 27 pts showed a large left to right shunt of more than 30 per cent, and the remaining one pt had Eisenmenger complex. In 15 of 16 pts demonstrated VSD with the pouch formation of the septal leaflet (PSL) by 2DE, MPAP was lower than 25 mmHg. These 16 pts showed various left to right shunt ratios (small to large). In all 4 pts demonstrated VSD with membranous septal aneurysm (MSA) and 1 pt demonstrated no findings by 2DE, MPAP was low (under 25 mmHg) and a left to right shunt was small. Group II included 400 pts with membranous VSD (aged 11 days to 15 years) diagnosed clinically. All 221 pts demonstrated VSD had PSL or MSA. PSL was demonstrated in 261 pts, MSA in 27 pts, both PSL and MSA in 33 pts and no findings in 79 pts by 2DE. Group III included 41 pts with spontaneous closed VSD (aged 3 months to 8 years) diagnosed clinically. PSL was demonstrated in 15 pts, MSA in 11 pts and no findings in 15 pts by 2DE. On the basis of these observation, PSL and MSA may play an important role in spontaneous diminution or closure of membranous VSD, and in most of VSD pts without PSL and MSA pulmonary hypertension is shown and spontaneous diminution of VSD size can not be anticipated. Visualization of PSL and MSA by 2DE may predict the prognosis and is clinically very useful in the management of pts with isolated membranous VSD.

Blood Pressure↗
PubMed1981

Cardiac biopsy of Kawasaki disease.

Two hundred one patients (138 boys, 63 girls), 1 month to 11 years old, with Kawasaki disease underwent coronary angiography, ultrasonic tomography, myocardial imaging, and biopsy of right ventricular myocardium. Aneurysms of epicardial coronary arteries, mostly left, occurred in 26 cases (12.9%). Degeneration and proliferation of endothelium, edema, scarring, and fibrosis, slight to moderate, involved the tunicae of intramural small vessels in all cases. These changes tended to abate with time. The basic lesion of Kawasaki disease, round-cell myocarditis and fibrosis, involved all cases and persisted. Disarrangement, abnormal branching, disarray, and hypertrophy of myocytes correlated significantly with myocarditis, but not with epimural or intramural coronary angitis. As a consequence of the myocardial changes, it is suggested that some cases may terminate as myocardiopathy. Scoring criteria for vascular and myocardial changes in biopsy specimens are included.

Biopsy↗