Biomedical subjects

T Onuki

Publications and source records attributed to T Onuki.

At least 55 records · Page 3Linked to original sources

PubMed1993

[A case of old pulmonary tuberculosis with repeated hemoptysis which presented therapeutic difficulties].

A 74-year-old male who had been infected with pulmonary tuberculosis since 1938 underwent thoracoplasty in 1955. After the operation, no symptoms manifested until 1988 when he developed hemosputum and hemoptysis in association with a cold with fever. Although he was admitted to a hospital, the symptoms could not be controlled, so he was referred to our department. The lesion causing the hemorrhage was considered to be in the upper lobe of the left lung. However, it would have been difficult to preserve respiratory function in the case of left upper lobectomy, because he had already undergone thoracoplasty on the right side. Therefore, bronchial artery embolization (BAE) using Spongel was performed. Second embolization was performed because hemoptysis referred after one month. However, the hemoptysis recurred again, so that two branches of the left subclavian artery and the left internal thoracic artery were ligated. No hemoptysis and hemosputum occurred for a while, but 2 years and 9 months after the operation, the patient was admitted due to hemoptysis with fever and coughing. Since the bronchial artery was embolized twice with spongel and twice with platinum coil, the patient's course has been good for 5 months.

Aged↗

PubMed1993

[Right ventricular myxoma with near obstruction of the pulmonary artery].

Right ventricular myxoma is very rare. To our knowledge, only 23 cases in Japan have been reported in the literature. A 76-year-old male was admitted with complaints of cough and dyspnea. We found an abnormal floating mass in the right ventricular outflow tract by echocardiography and cineangiocardiography. The digital subtraction angiography showed that the following mass continuously lodged in the pulmonary artery with total occlusion of the left main pulmonary artery and near obstruction of the right pulmonary artery. Furthermore he had the constitutional signs of myxoma and the serum IL-6 level reached 41.7 pg/ml. Under extra-corporeal circulation, we salvaged the right ventricular outflow tract to the right lung, resecting the tumor, originated from the right ventricular septum and extended to bilateral main pulmonary arteries.

Aged↗

PubMed1993

[A case of bilateral coronary artery fistulae into main pulmonary artery].

A case of coronary-pulmonary artery fistulae was presented with the review of the literature. A 46-year-old man was admitted to our department with an ischemic change in leads III, a VF on ECG. Although he had no complaint, the exercise ECG showed significant depression of ST segment in leads II, III, V4, V5. Coronary angiography revealed fistulae from left anterior descending branch to main pulmonary artery, and also from right coronary artery to main pulmonary artery. No coronary organic narrowing were found. Ligation of the fistulae was performed and postoperative course was uneventful.

Arterio-Arterial Fistula↗

PubMed1991

[Clinical analysis of male urethritis].

We reviewed 497 patients with male urethritis diagnosed between January, 1986 and March, 1989 at the Asama General Hospital. The incidence of gonococcal urethritis (GU) was 47.7%, and that of non-gonococcal urethritis (NGU) 52.3%. There was no difference in the age distribution between GU and NGU. Prostitutes were the most common source of the infection in both GU and NGU. Incubation periods were longer in NGU than in GU, statistically. Urethral discharge was the most common symptom. Purulent urethral discharge was seen more commonly than serous urethral discharge in GU. On the contrary, serous urethral discharge was more common in NGU. Penicillin-resistant gonococcus comprised 29.4% and mixed infection of the C. trachomatis existed 25.6% in GU. C. trachomatis was detected in 71.8% in NGU. In GU, new quinolones and penicillins were administered frequently. The effective rates 1 week after the administration were 80.6% and 83.3%, respectively. In NGU, new quinolones and minocycline were administered frequently. The effective rates were 70.4% and 85.3%, respectively. Ofloxacin (OFLX) showed the highest effective rate to NGU among the four new quinolones. The relapse rate for the two-week administration group was lower than that for the one-week-administration group, but the difference was not statistically significant.

Adolescent↗

PubMed1991

[Perioperative cardiac complications of pulmonary operations in patients with/without coronary stenosis].

It has been suggested that the presence of ischemic heart disease correlates with an increased risk of cardiac infarction and fatal arrhythmia following noncardiac operations. To prevent these complications, coronary arteriographies were performed on 55 patients before pulmonary surgery for the assessment of the risk of perioperative cardiac complications. A coronary artery obstruction, with a 50% or greater reduction in the internal diameter was recognized on 21 patients (Group 1) and the other 34 patients showed no significant coronary stenotic lesions (Group 2). Discriminant analysis revealed that cardiac index (p less than 0.025), blood sugar level (p less than 0.05), hyperlipidemia (p less than 0.05) and postoperative cardiac failure (p less than 0.005) correlated independently with coronary artery stenosis. Postoperative cardiac complications were observed in the form of atrial arrhythmias (11%), ventricular arrhythmias (16%) and ischemic ECG findings (17%) in all cases. The rate of occurrence of these complications were not different between the two groups. However, the need for therapeutic procedures for perioperative circulatory failure (18%) was much greater in group 1 (p less than 0.005). This study supports the merits of preoperative coronary arterial angiography and the estimation of the left ventricular function in reducing pulmonary perioperative risk.

Aged↗

PubMed1991

[A case of bronchial anastomotic stenosis after right upper sleeve lobectomy treated with silicone stent].

A case treated with silicone stent for bronchial granulomatous stenosis caused by anastomosis after right upper sleeve lobectomy was reported. A 68-year-old man complained of atelectasis of right upper lobe due to squamous cell carcinoma was admitted to our department. We performed right upper sleeve lobectomy. Four weeks after the operation, hemoptysis and dyspnea appeared with developing local empyema. We performed closure of pleural fistula and thoracoplasty, however, did not improve the symptoms. We performed tracheotomy for deteriorating dyspnea. In addition, granulomatous stenosis of bronchial anastomotic site was observed endoscopically. We tried to insert silicone stent into stenotic site. Although, first trial was in failure, we modified the design of the stent and succeeded in fixation of the stent. The airway was completely re-opened and good patency had been maintained for 7 months until his death due to pneumonia.

Aged↗

PubMed1991

Tubuloglomerular feedback resetting in different models of acute volume expansion.

Our results revealed that renal blood flow (RBF) increased during both isooncotic and hypooncotic plasma expansion by 4% of body weight (BW). Tubuloglomerular feedback (TGF) sensitivity assessed by the measurement of proximal stop-flow pressure at loop perfusion rates of 0 to 40 nl/min and RBF autoregulation were not substantially affected by this degree of volume expansion, provided plasma oncotic pressure did not change. This upward shift of the TGF response curve together with maintenance of an RBF autoregulation during plasma expansion lead to the conclusion that the TGF mechanism apparently plays a significant role in the control of glomerular hemodynamics, despite the marked vasodilation occurring during acute volume expansion.

Animals↗

PubMed1991

[A case of pulmonary coccidioidomycosis].

A 55-year-old Japanese woman was admitted to our hospital, complaining of flu-like symptoms and left-sided chest pain. Her chest X-ray films revealed a solitary coin lesion in the left middle lung field. She had traveled to California and Arizona 3 months before being taken ill. Because of negative result in sputum cytology and trans-bronchial lung biopsy examination, open lung biopsy and wedge resection was performed. Histological examination revealed endosporulating spherules in a caseous lesion of the epithelioid granulomas, and fungal cultures demonstrated barrel-shaped arthropores. Pulmonary coccidioidomycosis was diagnosed. Coccidioidomycosis is a rare fungal disease found in certain endemic areas in the southwestern region of the United States. She had been infected during her travels in America, and this is the second case in Japan who had taken surgical intervention for pulmonary coccidioidomycosis.

Coccidioidomycosis↗

PubMed1991

[ECMO treatment for ARDS].

Between February 1988 and March 1990, ECMO was performed (veno-arterial perfusion; 3 cases, venovenous; one case) is 4 ARDS patients. However no patient could be weaned from ECMO (32-80 hours) and all died. The causes of deaths were attributed to the complications of ARDS itself that existed before ECMO therapy and ECMO was highly effective in providing temporally life support. We consider that entry criteria of ECMO should not be based on gas exchange alone and that lung compliance and circulatory insufficiency should be taken into account.

Adult↗

PubMed1990

[A two-year-old child with tracheal stenosis due to tracheostomy treated by end-to-end anastomosis of the trachea].

Successful operation performed on a 2-year-old boy with tracheal stenosis due to long-term intubation was reported. He was admitted to our department 1 year after a neurosurgical operation. Endoscopically, destruction of cartilage rings was observed just above the site of tracheostomy, and the tracheal wall was collapsed without a help of tracheal tube. Reconstruction of the trachea by circumferential resection and end-to-end anastomosis was done. During the operation, the patient was uniformly ventilated by tracheal tube through nasal intubation. After the operation, tracheal intubation was continued for 7 days, and anterior fixation of neck for 8 days. The postoperative course was uneventful and the patient remains asymptomatic 8 months after operation.

Anastomosis, Surgical↗

PubMed1990

[Correlation between slopes of pulmonary blood flow-driving pressure curve and routine pulmonary function].

In 91 preoperative cases of lung cancer, an attempt was made to correlate the slopes of pulmonary blood flow-driving pressure curve (delta DP/delta CI), as constructed from unilateral pulmonary arterial occlusion (UPAO) test values and pulmonary blood flow fraction values as measured by scintigraphy, with total pulmonary vascular resistance index (TPVRI) and pulmonary vascular resistance index (PVRI) and routine pulmonary function. FVC and FEV per unit body surface (BSA) were found to correlate, to same degree, with delta DP/delta CI, TPVRI and PVRI (p less than 0.05). delta DP/delta CI correlated significantly with FRC/BSA, whereas TPVRI and PVRI did not. 3) The inverse of the cardiac index (1/cardiac index) was shown to significantly correlate with TPVRI and PVRI (r = 0.64, 0.48), but poorly with delta DP/delta CI (r = 0.32). These results suggest that delta DP/delta CI might possibly provide a more useful quantitative index for the pulmonary vascular bed than TPVRI and PVRI.

Adult↗

PubMed1990

[A case report of coronary artery bypass surgery (3-SVG) in 80-year-old woman with acute respiratory failure].

A successful operation for a patient of unstable angina with hypoxia is reported. A 80-year-old woman was admitted with severe chest oppression. The selective coronary angiogram revealed 3-vessel disease. Symptoms were uncontrolled by medical therapy. Aorto-coronary bypass surgery (with 3-saphenous vein grafts) was followed by excellent post-operative course. The patient has been asymptomatic for more than 1 year after operation.

Acute Disease↗

PubMed1990

[A case of mitral regurgitation caused by necrosis and total rupture of the papillary muscle].

Mitral regurgitation (MR) caused by total rupture of the papillary muscle has so ominous prognosis that it is treated by surgery exceedingly rarely. We recently experienced a case of MR caused by total rupture of the posterior papillary muscle that had presumably occurred after myocardial infarction. The patient was a 52-year-old male who was admitted to a hospital with liver dysfunction where he was noticed for the first time of his having cardiac murmurs and was diagnosed as having MR on the basis of echocardiography. With this diagnosis he was transferred to our department. Examination on admission revealed the patient to have an NYHA class III mitral incompetence with ECG evidence of old posteroinferior myocardial infarction. Cardiac catheterization demonstrated total occlusion of the segment 1 of the right coronary artery and MR, Sellers III. Abnormal echoes were noted in the left ventricle that moved almost synchronously with the posterior leaflet of the mitral valve, a finding leading to a suspected diagnosis of rupture of the posterior papillary muscle or chordae tendineae. Intraoperative findings were confirmative of total rupture of the posterior papillary muscle and mitral valve replacement was performed using a SJM prosthetic valve. Histological examination of the ruptured muscle revealed presence of necrosis, but no other specific inflammatory changes. Documented cases of surgically treated total papillary muscle rupture are quite limited in number, the present case being the 4th to be reported in Japan.

Heart Rupture↗

PubMed1987