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Biomedical subjects

S Onikura

Publications and source records attributed to S Onikura.

10 recordsLinked to original sources
PubMed1990

[Smoldering leukemia with pyoderma gangrenosum].

A 76-year-old male admitted to Surugadai Nihon University hospital complaining of general fatigue, slight fever and anorexia. The laboratory examination revealed anemia and an appearance of a few myeloblasts and 7% of monocytes in the peripheral blood. The nucleated cell count was 2 x 10(4)/microliters with 43% myeloblasts in the bone marrow aspirate. He was diagnosed as acute myelomonocytic leukemia. He did not receive any chemotherapy for leukemia because of his old age and smoldering disease. Pyoderma gangrenosum developed in the left submandibular and axillary regions about 6 months later. Three more month later, significant increase of myeloblast was recognized in the peripheral blood and the bone marrow. It has been reported that pyoderma gangrenosum precedes a remarkable increase of leukemic cells in the patients with acute leukemia in complete remission and with myelodysplastic syndrome. In our case, to, the same process was strongly suggested.

Aged↗
PubMed1989

Complete atrioventricular block associated with regional myocardial scarring in a patient with Coxsackie B2 myocarditis.

Transient atrioventricular (A-V) conduction abnormalities are often experienced in patients with evolving acute viral myocarditis, but persistent complete A-V block requiring permanent cardiac pacing is rare. We describe a case who developed irreversible complete A-V block during the long-term course of Coxsackie B2 myocarditis. The endomyocardial biopsy revealed inflammatory cellular infiltrates and myocyte necrosis. A left ventriculogram and echocardiogram consistently demonstrated an aneurysm in the basal portion of the interventricular septum. It was speculated that the extensive myocardial scar caused by acute myocarditis resulted in the ventricular aneurysm of this particular myocardial region involving the A-V conduction system.

Adult↗
PubMed1988

Experimental and clinical investigations for the time interval from onset of symptoms to the coronary reperfusion.

To clarify the relationship between time interval from the onset of coronary occlusion to the reperfusion and reperfusion rates or left ventricular function, an experiment with 113 mongrel dogs was carried out. Coronary thrombi experimentally induced within 4 hours in 63 dogs were rapidly lysed by intracoronary thrombolytic agent (Experiment 1). Infarct size was investigated in 17 dogs. The infarct size (% of left ventricle) in 9 dogs with 4-hour reperfusion following 2-hour coronary occlusion was significantly smaller than that in 8 dogs with 6-hour occlusion (12.0 +/- 7.9 vs 19.1 +/- 8.7% respectively p less than 0.05) (Experiment 2). The infarct size in 8 dogs with 7-day reperfusion following 2-hour occlusion was also significantly reduced compared to that in 7 dogs with 7-day occlusion (16.3 +/- 7.4 vs 28.5 +/- 8.9%, respectively p less than 0.02) (Experiment 3). The infarct size in 11 dogs with 4-hour reperfusion with verapamil administration following 2-hour occlusion was significantly reduced compared to that in 7 dogs with 6-hour occlusion without verapamil (5.5 +/- 1.9 vs 20.3 +/- 3.3%, respectively p less than 0.01) (Experiment 4). In experiment 3, anterior wall motion also was assessed by contrast ventriculography and infarct related areas in reperfused group was found to be improved compared to non-reperfused group at 7 days after infarction. In clinical studies, 121 patients who were admitted within 12 hour of onset of symptoms, were investigated to evaluate reperfusion rates and left ventricular function. The reperfusion rate of young age thrombus within 3 hours was 89% of 18 patients with completely occluded coronary artery. It was 77% of the 52 patients with 3 to 6 hour occlusion and 72% of the 18 patients with over 6 hour occlusion. There was a tendency towards high reperfusion rates in younger thrombus. In patients who were recanalized within 3 hours from the onset of symptoms ejection fraction of left ventricle at the chronic stage had a significantly higher percentage when compared to the unsuccessful group. Wall motion of infarct-related areas in patients who were thrombolysed within 6 hours was improved compared to the unsuccessful group. Administration of verapamil during reperfusion in patients with acute myocardial infarction suppressed rapid CK release and sigma CK. Thus, young age thrombus can be lysed easily, earlier recanalization after coronary occlusion can reduce infarct size and improve left ventricular function. Reinforced administration of verapamil during reperfusion can also reduce infarct size.

Adult↗
PubMed1988

[The significance of early coronary reperfusion in patients with acute myocardial infarction assessed by regional wall motion].

Left ventricular ejection fraction, regional wall motion, hospital mortality rate, and reocclusion rate of the infarct-related coronary artery after thrombolytic therapy were examined in 164 consecutive patients who were admitted within 12 hours of the onsets of their symptoms of acute myocardial infarction. The patients were divided into three groups based on the findings of initial coronary angiography before and after administration of urokinase: (1) stenosed (the infarct-related coronary blood flow was visualized at initial angiography) (n = 41); (2) successfully thrombolysed (n = 82); and (3) unsuccessful (n = 41). The patients in each group were also subdivided into three subgroups based on the recanalized time (hours): within three, three to six hours and six hours or longer. The hospital mortality rates were 4.9% (two of the 41 patients) in the stenosed; 8.5% (seven of the 82 patients) in the thrombolysed; 29.3% (12 of the 41 patients) in the unsuccessful group, and 12.8% (21 of the 164 patients) overall, respectively. There were significant differences among these three groups. The incidence of pump failure as a cause of death in the acute stage was significantly low in the stenosed (two of the 41 patients) and in the thrombolysed (3 of the 82 patients) groups compared to the unsuccessful group (eight of the 41 patients). The rates of rethrombosis one month after thrombolytic treatment were 3% in the stenosed and 4% in the thrombolysed groups. On the contrary, visualization of coronary blood flow at the chronic stage (approximately one month later) was confirmed in 19% of the patients in the unsuccessful group. Left ventricular ejection fraction one month after thrombolytic therapy in the subgroup with the recanalized coronary arteries within three hours was significantly higher than that of the unsuccessful group, but, after three hours of procedure, no significant difference of left ventricular ejection fraction was present among three groups. Regional wall motion in patients with the recanalized coronary artery within 12 hours was better than that of the unsuccessful group. The area of improved wall motion was wide in patients with early recanalization in the stenosed and thrombolysed groups. Thus, early recanalization within three hours is mandatory for reducing mortality and for improving ejection fraction and wall motion.

Humans↗
PubMed1985

Indications for and limitations of coronary thrombolysis.

Experimental studies in dogs with coronary thrombi induced by copper wire confirmed the optimal method of intracoronary thrombolysis, and showed that a high-dose, brief intravenous infusion of urokinase can lead to recanalization. The thrombolytic effects of intracoronary thrombolysin at a rate of 50 IU/kg over 10 minutes are similar to the effects of intracoronary urokinase at a rate 500 IU/kg over 20 minutes. Overall reperfusion rates of 83-86% have been achieved. These results indicate that the thrombolytic effect of thrombolysin is 20 times stronger than that of urokinase. The effect of a brief intravenous infusion of urokinase was less than that of intracoronary urokinase. The reperfusion rate in the same experimental model was 40%. Later, a clinical trial of intracoronary urokinase was performed in 47 patients with acute myocardial infarction who were admitted within 12 hours of the onset of symptoms. In 25 of 33 (75.8%) patients with complete occlusion, selective or ostial infusion of urokinase 500 IU/kg over 20 minutes was successful. When given intravenously, recanalization was achieved in 11 of 15 (73%) patients with complete occlusion who were admitted within 6 hours. Both reperfusion rates were similar except for dosage and the duration of infusion.

Aged↗