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Narui K, Satake T, Ishikawa T, Muto M, Tsunoda Y, Yamada A, Kawashima K, Uenaka N, Fujiwara Y, Oshi M, Adachi S, Suzuki C, Wada T, Yamamoto S, Tanabe M, Maegawa J, Endo I. Endoscopic mastectomy followed by immediate breast reconstruction with fat grafting for breast cancer. Breast Cancer 2024; 31:476-484. [PMID: 38512534 DOI: 10.1007/s12282-024-01561-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/24/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Although endoscopic mastectomy has been associated with good tolerance and enhanced patient satisfaction, limitations such as the implant or flap size for reconstruction with small incisions remain unresolved. Fat grafting (FG) can expand tissue volume with pinhole skin incisions. Herein, we evaluated the safety and efficacy of endoscopic mastectomy followed by immediate FG. METHODS Patients who underwent endoscopic mastectomy with immediate FG reconstruction from 2015 to 2021 were retrospectively evaluated to establish surgical outcomes and prognosis. RESULTS Twenty-three patients with clinical stage 0 or I breast cancer underwent unilateral endoscopic mastectomy with immediate FG. The median age was 45 years (41-55), and the median body mass index was 19.3 kg/m2 (15.8-26.6). Endoscopically performed procedures included skin-sparing mastectomies in 18 patients (78%) and nipple-sparing mastectomies in five patients (22%). The median procedure duration was 295 min (242-346). The median specimen weight was 133 g (71-334), and the median grafted fat volume was 200 mL (136-320). No patient required reoperation or additional procedures for complications. One patient experienced recurrence at a median follow-up of 56.1 months and underwent resection; the patient was alive without recurrence 54 months post-resection. CONCLUSION To the best of our knowledge, this is the first report of endoscopic mastectomy with immediate FG for reconstruction. When compared with other immediate autologous reconstructions, our strategy could minimize the skin incision and procedure duration, as well as limit complications. Further prospective investigations are needed to evaluate oncological safety, surgical outcomes, and patient satisfaction.
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Affiliation(s)
- Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan.
| | - Toshihiko Satake
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Toyama, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo, Tokyo, Japan
| | - Mayu Muto
- Department of Plastic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Yui Tsunoda
- Department of Plastic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Akimitsu Yamada
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kei Kawashima
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Natsuki Uenaka
- Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo, Tokyo, Japan
| | - Yoshie Fujiwara
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Masanori Oshi
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Shoko Adachi
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Chiho Suzuki
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Tomoko Wada
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Shinya Yamamoto
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Mikiko Tanabe
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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Kokubo K, Katori N, Hayashi K, Fujii A, Koike T, Mizuki N, Hayashi A, Maegawa J. Comparison of postoperative recurrence rates between percutaneous and transconjunctival approaches for involutional entropion. J Plast Reconstr Aesthet Surg 2023; 83:16-22. [PMID: 37270992 DOI: 10.1016/j.bjps.2023.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/11/2023] [Indexed: 06/06/2023]
Abstract
Lower eyelid entropion is the second most common disease seen after ptosis in oculoplastic outpatients. In this study, we performed percutaneous and transconjunctival shortening of the anterior and posterior layers of the lower eyelid retractor (LER) to treat lower eyelid involutional entropion. This study aimed to examine the recurrence rate and complications of the percutaneous and transconjunctival approaches. This was a retrospective study of procedures conducted from January 2015 to June 2020. The LER shortening was performed for lower eyelid involutional entropion on 103 patients (116 eyelids). From January 2015 to December 2018, LER shortening using the percutaneous approach was implemented; from January 2019 to June 2020, the transconjunctival approach was used to shorten the LER. All patient charts and photographs were retrospectively reviewed. Recurrence occurred in 4 patients (4.3%) in the percutaneous approach. No recurrence was observed in any patient in the transconjunctival approach. Temporary ectropion occurred in 6 patients (7.6%) when the percutaneous approach was used; all cases healed within 3 months after surgery. The study did not reveal any statistically significant difference in recurrence rates between the percutaneous and transconjunctival approaches. We achieved results equal to or better than percutaneous LER shortening by combining transconjunctival LER shortening with horizontal laxity shortening, such as lateral tarsal strip, pentagonal resection, and orbicularis oculi muscle resection. However, it is necessary to be careful about temporary ectropion after surgery when percutaneous LER shortening alone is performed for lower eyelid entropion.
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Affiliation(s)
- Kenichi Kokubo
- Department of Plastic Surgery, Fujisawa Shounandai Hospital, 2345 Takakura, Fujisawa-shi, Kanagawa 251-0802, Japan; Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan.
| | - Nobutada Katori
- Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-shi, Shizuoka 430-8558, Japan
| | - Kengo Hayashi
- Yokohama Sakuragicho Eye Clinic, 1-200 Hinodecho, Naka-ku, Yokohama-shi, Kanagawa 231-0006, Japan
| | - Akiko Fujii
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Tomoyuki Koike
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama-shi, Kanagawa 232-0024, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Ayato Hayashi
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
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Koike T, Kato N, Saito K, Kokubo K, Maegawa J. Rib osteochondral graft for scaphoid proximal pole reconstruction. J Plast Surg Hand Surg 2023; 57:225-229. [PMID: 35195058 DOI: 10.1080/2000656x.2022.2039681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND An irreparable scaphoid proximal pole is challenging to treat because of the fragment size and limited blood supply. Salvage surgery, such as partial wrist fusion or proximal row carpectomy, may be performed but is not ideal for young patients. There are few reports of proximal scaphoid reconstruction using rib osteochondral grafts. METHODS Four patients were treated with rib osteochondral graft for reconstruction of the scaphoid proximal pole. The patients had a mean postoperative follow-up of 24 months. The mean age at the time of surgery was 30 years. Outcome measurements included total active range of wrist motion arc, grip strength, and wrist function score. We also evaluated the progression of osteoarthritis and changes in carpal height. RESULTS No complications occurred at the donor site. The range of motion improved from 82° to 95° before and after surgery. Grip strength improved from 22 kg to 33 kg before and after surgery. There was a remarkable improvement in the modified wrist function scores of Green and O'Brien from 40 points to 70 points before and after surgery. No progression of arthrosis was seen on the radiographs of all the patients. There was no significant difference in the carpal height ratio before and after surgery. CONCLUSIONS Proximal scaphoid fractures may require reconstruction of the articular surfaces of the radius, capitate, and lunate. Reconstruction with a rib osteochondral graft is flexible, easy to fabricate, and can reconstruct the three articular surfaces.
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Affiliation(s)
- Tomoyuki Koike
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan.,Hand Surgery Center, National Hospital Organization Murayama Medical Center, Musashimurayama, Japan
| | - Naoki Kato
- Hand Surgery Center, National Hospital Organization Murayama Medical Center, Musashimurayama, Japan
| | - Kenta Saito
- Orthopaedic Surgery, Konan Hospital, Shimotsuma, Japan
| | - Kenichi Kokubo
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan
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Murota Y, Satake T, Tsunoda Y, Muto M, Koike T, Onoda S, Maegawa J. Stacked deep inferior epigastric perforator with sequential lumbar artery perforator flaps for bilateral breast reconstruction: A case report. Microsurgery 2022; 42:829-834. [PMID: 36043502 DOI: 10.1002/micr.30954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/06/2022] [Accepted: 08/12/2022] [Indexed: 11/06/2022]
Abstract
Breast size that can be reconstructed with a single flap is limited in thin patients who need bilateral autologous large-volume breast reconstruction. We present the case of a 39-year-old female with bilateral heterogeneous breast cancer. The patient underwent total mastectomy and radiation therapy on the left side and nipple sparing mastectomy on the right. We planned to use the stacked deep inferior epigastric perforator (DIEP) with sequential lumbar artery perforator (LAP) flaps because the patient's thigh was too thin and she refused using gluteal tissue. The flap was 10 cm wide at the abdomen, 5 cm wide at the waist, and 72 cm long overall. The DIEP and LAP flaps were harvested as one continuous flap and were folded onto each other to create a breast mound. The lumbar artery and vein were anastomosed to the distal stump of the deep inferior epigastric artery and vein (DIEA/V) intraflaps, and then, the proximal stump of the DIEA/V was anastomosed to the internal mammary artery and vein. The LAP flaps were placed deeply, whereas the DIEP flaps were placed superficially. Whole skin was de-epithelialized on the right side, and skin damaged by radiotherapy was released and replaced with abdominal skin on the left side. The flap survived fully, the shape of the reconstructed breasts was good, and the body line on the donor side was well maintained. We present the stacked DIEP with sequential LAP flaps as one of the options for bilateral breast reconstruction in thin patients with larger breast size.
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Affiliation(s)
- Yumiko Murota
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Toshihiko Satake
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Japan
| | - Yui Tsunoda
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Tomoyuki Koike
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Satoshi Onoda
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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Koike T, Yabuki Y, Miki N, Yamamoto Y, Kokubo K, Kitayama S, Maegawa J. VISUALIZATION OF LOWER EXTREMITY LYMPHEDEMA IN THE SAME COHORT USING (^99m)Tc-HUMAN SERUM ALBUMIN AND (^99m)Tc-PHYTATE LYMPHOSCINTIGRAPHY WITH SPECT-CT. Lymphology 2022. [DOI: 10.2458/lymph.5138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Lymphoscintigraphy with single-photon emission computed tomography (SPECT-CT) is useful in diagnosing lymphedema. However, there are multiple timings, techniques, and tracers utilized worldwide without any comparison. We examined and compared the image clarity with two different radiotracers, 99mTc-human serum albumin (HSA) and 99mTc-phytate (phytate), in the same patients. The study retrospectivity examined 46 limbs of 36 patients who underwent lymphoscintigraphy using HSA and phytate from January 2013 to September 2018. Tracer accumulation in the lymph nodes, linear pattern (LP), and dermal backflow (DBF) were qualitatively analyzed; contrast-to-noise ratios (CNR) of DBF and standardized uptake value ratio (SUVR) of LP were also quantitatively analyzed. Neither lymph node accumulation nor DBF identification showed significant difference. However, a significant difference was observed between the LP identification of the unaffected (p<0.001) and affected sides (p<0.001). On quantitative evaluation, CNR and SUVR of LP was significantly higher with HSA than with phytate (p<0.001). SUVR of LP was also significantly higher with HSA than with phytate in both unaffected (p=0.002) and affected (p=0.005) sides. Overall, images acquired with HSA were clearer than that with phytate, and the identification of LP was particularly better with HSA than with phytate. Thus, lymphoscintigraphy using HSA is preferred over phytate for both diagnosis and evaluation of disease severity and surgical site selection.
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Affiliation(s)
- T. Koike
- Yokohama City University Medical Center
| | - Y. Yabuki
- Yokohama City University Medical Center
| | - N. Miki
- Yokohama City University Medical Center
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Satake T, Muto M, Okamoto M, Onoda S, Matsui K, Narui K, Kobayashi S, Fujii T, Ishikawa T, Maegawa J. Double-pedicle unaffected split-breast flap for unilateral breast reconstruction. Microsurgery 2022; 42:441-450. [PMID: 34985152 DOI: 10.1002/micr.30861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/29/2021] [Accepted: 12/28/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND In some breast cancer patients with a contralateral unaffected hypertrophic and ptotic breast, autologous small-breast reconstruction with contralateral breast reduction is a good option. The current study is aimed to assess the efficacy of the double-pedicle unaffected split-breast (USB) flap harvested from the central half of the unaffected breast for unilateral breast reconstruction with contralateral transverse scar reduction mammoplasty. METHODS Between February 2003 and May 2020, 14 patients underwent breast reconstruction using the USB flap. The mean patient age was 59.1 (range: 48-76) years, and the mean body mass index was 24.2 (range: 19.5-33.3) kg/m2 . This flap comprised half of the contralateral breast tissues with the 3rd or 4th internal mammary perforator (IMAP) and the lateral thoracic vessel (LTA/V). After USB flap elevation and LTA/V resection, flap perfusion from the IMAP was evaluated on indocyanine green (ICG) angiography. The medial pedicle USB flap was rotated 180° and was transferred to the affected site via the midline. The LTA/V was anastomosed to the recipient vessel to supercharge the distal part of the USB flap, which was then used for breast reconstruction. Then, the remaining contralateral upper and lower breast poles were used for transverse scar reduction mammoplasty. RESULTS The mean flap size was 13.3 × 26.9 (range: 9.5 × 22 to 16 × 29) cm. All flaps and reduced breasts survived without serious complications such as flap necrosis, although there was one patient with hematoma and one patient with hypertrophic scar. ICG revealed poor perfusion in the distal, lateral part of the flap, ranging from 22.0% to 48.5% of the overall flap area. Final aesthetic evaluation was high, with 11 cases (78.6%) being "good" or "excellent" and 3 cases (21.4%) that were either poor or fair. The mean follow-up period for the patients was 53.8 (range: 15-84) months, with none of the patients presenting second primary breast cancer or recurrence in both breasts. CONCLUSION USB flap breast reconstruction with contralateral reduction mammoplasty is a valuable option in breast cancer patients with a hypertrophic and ptotic breast.
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Affiliation(s)
- Toshihiko Satake
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Maki Okamoto
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Japan
| | - Satoshi Onoda
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Japan
| | - Koshi Matsui
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Tsutomu Fujii
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Takashi Ishikawa
- Department of Breast Oncology and Surgery, Tokyo Medical University Hospital, Shinjuku, Tokyo, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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Koike T, Yabuki Y, Miki N, Yamamoto Y, Kokubo K, Kitayama S, Maegawa J. Visualization of lower extremity lymphedema in the same cohort using 99mTc-human serum albumin and 99mTc-phytate lymphoscintigraphy with SPECT-CT. Lymphology 2022; 55:1-9. [PMID: 35896110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Lymphoscintigraphy with single-photon emission computed tomography (SPECT-CT) is useful in diagnosing lymphedema. However, there are multiple timings, techniques, and tracers utilized worldwide without any comparison. We examined and compared the image clarity with two different radiotracers, 99mTc human serum albumin (HSA) and 99mTc phytate (phytate), in the same patients. The study retrospectivity examined 46 limbs of 36 patients who underwent lymphoscintigraphy using HSA and phytate from January 2013 to September 2018. Tracer accumulation in the lymph nodes, linear pattern (LP), and dermal backflow (DBF) were qualitatively analyzed; contrast-to-noise ratios (CNR) of DBF and standardized uptake value ratio (SUVR) of LP were also quantitatively analyzed. Neither lymph node accumulation nor DBF identification showed significant difference. However, a significant difference was observed between the LP identification of the unaffected (p<0.001) and affected sides (p<0.001). On quantitative evaluation, CNR and SUVR of LP was significantly higher with HSA than with phytate (p<0.001). SUVR of LP was also significantly higher with HSA than with phytate in both unaffected (p=0.002) and affected (p=0.005) sides. Overall, images acquired with HSA were clearer than that with phytate, and the identification of LP was particularly better with HSA than with phytate. Thus, lymphoscintigraphy using HSA is preferred over phytate for both diagnosis and evaluation of disease severity and surgical site selection.
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Affiliation(s)
- T Koike
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Y Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - N Miki
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Y Yamamoto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - K Kokubo
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - S Kitayama
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - J Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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Kobayashi S, Mizuno Y, Suzuki M, Yasumura K, Hirakawa T, Fukawa T, Yabuki Y, Satake T, Maegawa J. Posterior pharyngeal wall augmentation using autologous tiered costal cartilage for velopharyngeal insufficiency. J Plast Reconstr Aesthet Surg 2022; 75:e1-e6. [DOI: 10.1016/j.bjps.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 09/09/2021] [Accepted: 01/08/2022] [Indexed: 11/28/2022]
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Mikami T, Homma Y, Tamanoi Y, Yabuki Y, Kawabata Y, Kato I, Iwai T, Shimada K, Maegawa J. Pectoralis major myocutaneous flap revisited as a workhorse for reconstruction for defects in the upper arm: A case report. J NIPPON MED SCH 2022. [DOI: 10.1272/jnms.jnms.2023_90-401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Taro Mikami
- Department of Plastic and Reconstructive Surgery, Chigasaki Municipal Hospital
| | - Yuki Homma
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine
| | - Yoshihiko Tamanoi
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine
| | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine
| | - Yusuke Kawabata
- Department of Orthopedic Surgery, Yokohama City University School of Medicine
| | - Ikuma Kato
- Department of Molecular Pathologiy, Yokohama City University Graduate School of Medicine
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate school of Medicine
| | | | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine
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Akita S, Unno N, Maegawa J, Kimata Y, Ota Y, Yabuki Y, Shinaoka A, Sano M, Ohnishi F, Sakuma H, Nuri T, Ozawa Y, Shiko Y, Kawasaki Y, Hanawa M, Fujii Y, Imanishi E, Fujiwara T, Hanaoka H, Mitsukawa N. A phase III, multicenter, single-arm study to assess the utility of indocyanine green fluorescent lymphography in the treatment of secondary lymphedema. J Vasc Surg Venous Lymphat Disord 2021; 10:728-737.e3. [PMID: 34592477 DOI: 10.1016/j.jvsv.2021.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Indocyanine green (ICG) fluorescent lymphography might be useful for assessing patients undergoing lymphatic surgery for secondary lymphedema. The present clinical trial aimed to confirm whether ICG fluorescent lymphography would be useful in evaluating lymphedema, identifying lymphatic vessels suitable for anastomosis, and confirming patency of lymphaticovenular anastomosis in patients with secondary lymphedema. METHODS The present phase III, multicenter, single-arm, open-label, clinical trial (HAMAMATSU-ICG study) investigated the accuracy of lymphedema diagnosis via ICG fluorescent lymphography compared with lymphoscintigraphy, rate of identification of lymphatic vessels at the incision site, and efficacy for confirming patency of lymphaticovenular anastomosis. The external diameter of the identified lymphatic vessels and the distance from the skin surface to the lymphatic vessels using preoperative ICG fluorescent lymphography were measured intraoperatively under surgical microscopy. RESULTS When the clinical decision for surgery at each research site was made, the standard diagnosis of lymphedema was considered correct. For the 26 upper extremities, a central judgment committee who was unaware of the clinical presentation confirmed the imaging diagnosis was accurate for 100.0% of cases, whether the assessments had been performed via lymphoscintigraphy or ICG lymphography. In contrast, for the 88 lower extremities, the accuracy of the diagnosis compared with the diagnosis by the central judgment committee was 70.5% and 88.2% for lymphoscintigraphy and ICG lymphography, respectively. The external diameter of the identified lymphatic vessels was significantly greater in the lower extremities than in the upper extremities (0.54 ± 0.21 mm vs 0.42 ± 0.14 mm; P < .0001). Also, the distance from the skin surface to the lymphatic vessels was significantly longer in the lower extremities than in the upper extremities (5.8 ± 3.5 mm vs 4.4 ± 2.6 mm; P = .01). For 263 skin incisions, with the site placement determined using ICG fluorescent lymphography, the rate of identification of lymphatics vessels suitable for anastomosis was 97.7% (95% confidence interval, 95.1%-99.2%). A total of 267 lymphaticovenular anastomoses were performed. ICG fluorescent lymphography was judged as "useful" for confirming patency after the anastomosis in 95.1% of the cases. CONCLUSIONS ICG fluorescent lymphography could be useful for improving the treatment of patients with secondary lymphedema from the outpatient setting to surgery.
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Affiliation(s)
- Shinsuke Akita
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Naoki Unno
- Department of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan; Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Yusuke Ota
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Akira Shinaoka
- Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Masaki Sano
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Fumio Ohnishi
- Department of Plastic and Reconstructive Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe City, Japan
| | - Hisashi Sakuma
- Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Tokyo, Japan
| | - Takashi Nuri
- Department of Plastic and Reconstructive Surgery, Osaka Medical College, Takatsuki, Japan
| | - Yoshihito Ozawa
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yuki Shiko
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yohei Kawasaki
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Michiko Hanawa
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yasuhisa Fujii
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Eri Imanishi
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Tadami Fujiwara
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Hideki Hanaoka
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Nobuyuki Mitsukawa
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
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11
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Fujiyoshi T, Mikami T, Hashimoto K, Asano S, Adachi E, Kagimoto S, Yabuki Y, Kitayama S, Matsubara S, Maegawa J, Iwai T, Ishibe A, Miyagi E, Kaneta T. Pathological Changes in the Lymphatic System of Patients with Secondary Lower Limb Lymphedema Based on Single Photon-Emission Computed Tomography/Computed Tomography/Lymphoscintigraphy Images. Lymphat Res Biol 2021; 20:144-152. [PMID: 34415778 PMCID: PMC9081006 DOI: 10.1089/lrb.2021.0040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: In patients with secondary upper limb lymphedema, positive correlations have been observed between the dermal back flow (DBF) type and visualization of lymph nodes around the clavicle, between the former and the lymph flow pathway type, and between the latter and the visualization of lymph nodes around the clavicle when using single photon-emission computed tomography/computed tomography/lymphoscintigraphy (SPECT-CT LSG). Methods and Results: We analyzed the associations between the visualization of inguinal lymph nodes, the lymph flow pathway type, and the DBF type using SPECT-CT LSG in 81 patients with unilateral secondary lower limb lymphedema by statistical analysis using Fisher's exact test. We revealed that the lymph flow pathways in the lower limb can be classified into nine types because the type in the lower leg is not always equal to the type in the thigh. Associations were observed between the visualization of inguinal lymph nodes and types of DBF (p < 0.01), between the types of lymph flow pathway in the thighs and visualization of the inguinal lymph nodes (p = 0.02), and between the lymph flow pathway types in the thighs and lower legs (p < 0.01). Conclusion: Detriment to the superficial lymph flow pathways in the lower limb appears to usually start from the proximal side, and deep pathways are considered to become dominant from a compensatory perspective as lymphedema severity increases.
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Affiliation(s)
| | - Taro Mikami
- Department of Plastic and Reconstructive Surgery, Chigasaki Municipal Hospital, Chigasaki, Japan
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
- Address correspondence to: Taro Mikami, MD, PhD, Department of Plastic and Reconstructive Surgery, Chigasaki Municipal Hospital, Honson 5-15-1, Chigasaki 253-0042, Japan
| | - Koukichi Hashimoto
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
| | - Saori Asano
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
| | - Eiko Adachi
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shintaro Kagimoto
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shinya Kitayama
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shinobu Matsubara
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery and School of Medicine, Yokohama City University, Yokohama, Japan
| | - Toshinori Iwai
- Department of Maxillofacial Surgery, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Atsushi Ishibe
- Department of Gastroenterological Surgery and Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomohiro Kaneta
- Department of Advanced Molecular Imaging, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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12
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Kobayashi S, Fukawa T, Satake T, Maegawa J. Considering the view from the inside of the maxillary sinus in Le Fort II osteotomy. J Plast Reconstr Aesthet Surg 2021; 74:1931-1971. [PMID: 33994110 DOI: 10.1016/j.bjps.2021.03.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 02/18/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Mutsukawa 2-138-4, Minami-ku, Yokohama 232-8555, Kanagawa, Japan.
| | - Toshihiko Fukawa
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Mutsukawa 2-138-4, Minami-ku, Yokohama 232-8555, Kanagawa, Japan; Fukawa Orthodontic Office, Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Japan
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13
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Kobayashi S, Yasumura K, Mizuno Y, Suzuki M, Hirakawa T, Satake T, Yabuki Y, Maegawa J. A procedure combining double opposing Z-plasty with buccal flap and skin graft for a cleft palate patient with short palate. JPRAS Open 2021; 29:55-59. [PMID: 34124330 PMCID: PMC8175270 DOI: 10.1016/j.jpra.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 04/01/2021] [Indexed: 11/30/2022] Open
Abstract
Cleft palate patients with a short palate are sometimes encountered and it is difficult to achieve effective primary palatoplasty and good speech in these cases. Our purpose was to establish an effective palatoplasty for a cleft palate patient with Randall type III short palate. Buccal musculomucosal flap on the nasal side and skin graft on the oral side were performed, along with double opposing Z-plasty. Speech improved postoperation. This procedure brought the nasopharyngeal area closer to the normal anatomical state. In terms of disadvantages, the procedure is rather complicated and depends on the engraftment rate.
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Affiliation(s)
- Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center
| | - Kazunori Yasumura
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center
| | - Yuki Mizuno
- Department of speech therapy, Kanagawa Children's Medical Center
| | - Mayumi Suzuki
- Department of speech therapy, Kanagawa Children's Medical Center
| | | | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital
| | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital
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14
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Kokubo K, Katori N, Hayashi K, Fujii A, Kitamura S, Haga S, Maeda C, Mizuki N, Maegawa J. Comparison of postoperative recurrence rates between levator aponeurosis advancement and external Müller's muscle tucking for acquired blepharoptosis. J Plast Reconstr Aesthet Surg 2021; 74:3094-3100. [PMID: 33994326 DOI: 10.1016/j.bjps.2021.03.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/02/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
Treatment options for acquired blepharoptosis include levator resection, levator aponeurosis advancement (LAA), Müller's muscle-conjunctival resection (MMCR), and frontalis suspension. Previously, we reported a technique called external Müller's muscle tucking (EMMT) using the Müller's muscle as a power source. In this study, we compare LAA with EMMT and evaluate the recurrence and reoperation rates. LAA was performed on 96 eyelids in 51 patients. The average follow-up period was 12.2 months, recurrence occurred in four eyelids (4.2%) of three patients, and reoperation was required in one eyelid of one patient (2.0%). EMMT was performed on 94 eyelids in 51 patients, the mean follow-up period was 10.5 months, recurrence occurred in 14 eyelids (15%) of 10 patients, and reoperation was required in three eyelids of two patients (3.9%). A comparison of LAA and EMMT recurrence showed that EMMT was associated with a significantly higher recurrence rate (P = 0.0021). The causes of EMMT recurrence included thinning and fatty degeneration of Müller's muscles, necrosis of ligated Müller's muscles, and less postoperative scar formation. There was no correlation between EMMT recurrence and the severity of the blepharoptosis.
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Affiliation(s)
- Kenichi Kokubo
- Department of Plastic Surgery, Fujisawa Shounandai Hospital, 2345 Takakura, Fujisawa-shi, Kanagawa 251-0802, Japan.
| | - Nobutada Katori
- Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-shi, Shizuoka 430-8558, Japan
| | - Kengo Hayashi
- Yokohama Sakuragicho Eye Clinic, 1-200 Hinodecho, Naka-ku Yokohama-shi, Kanagawa 231-0006, Japan
| | - Akiko Fujii
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Sho Kitamura
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Shoko Haga
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Chie Maeda
- Department of Plastic Surgery, Fujisawa Shounandai Hospital, 2345 Takakura, Fujisawa-shi, Kanagawa 251-0802, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
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15
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Mikami T, Maeda C, Aoki F, Iwai T, Yabuki Y, Okabe T, Ohashi K, Maegawa J. A dermoid cyst misdiagnosed as a lipoma due to atypical magnetic resonance images: a case report. J Med Case Rep 2021; 15:99. [PMID: 33648548 PMCID: PMC7923823 DOI: 10.1186/s13256-020-02584-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 11/12/2020] [Indexed: 11/15/2022] Open
Abstract
Background Dermoid cysts are well-known lesions that manifest as subcutaneous tumors around the lateral sides of the eyebrows in young patients. Computed tomography or magnetic resonance imaging (MRI) is often performed to confirm the diagnosis. On the other hand, a lipoma is usually a circular lesion, which is sometimes observed in the upper part of the face. The signals of both T1-weighted and T2-weighted images of MRI of a lipoma are, in general, relatively highly homogenous, and the signals decrease in fat-suppressed images. Therefore, differential diagnosis between a dermoid cyst and a lipoma is usually made with MRI, especially based on fat-suppressed images. Here, we present a case of misdiagnosis of a dermoid cyst as a lipoma because of atypical magnetic resonance images. Case presentation We report a case of a 24-year-old Japanese woman with a dermoid cyst around the lateral edge of the eyebrow. The cyst had been gradually increasing in size for the past 2 years. On MRI, it showed high internal signals on T1- and T2-weighted images. However, the signal intensity decreased homogeneously in the fat-suppressed T2-weighted images. The observed tumor had a yellowish appearance under the endoscope. On the basis of these findings, the lesion was considered a lipoma until it ruptured intraoperatively. The pathological diagnosis confirmed it to be a dermoid cyst. Conclusion Some dermoid cysts contain lipid-rich liquid, and these may be misdiagnosed as lipomas by MRI. When a tumor is located at a common site for a dermoid cyst, the MRI images should be validated carefully if it appears like a lipoma, and the differential diagnosis should be considered carefully.
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Affiliation(s)
- Taro Mikami
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa, 236-004, Japan. .,Department of Plastic and Reconstructive Surgery, Chigasaki Municipal Hospital, Honson 5-15-1, Chigasaki, Kanagawa, 253-0042, Japan.
| | - Chie Maeda
- Department of Plastic and Reconstructive Surgery, Fujisawa-Shounandai Hospital, Takakura 2345, Fujisawa, Kanagawa, 252-0802, Japan
| | - Fumihiko Aoki
- Shonandai AOKI Plastic Surgery Clinic, Shonandai 2-10-7, Fujisawa, Kanagawa, 252-0804, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, 236-004, Japan
| | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa, 236-004, Japan
| | - Tetsuhiko Okabe
- Department of Radiology, Yokohama City University School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa, 236-004, Japan
| | - Kenichi Ohashi
- Department of Pathology, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa, 236-004, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa, 236-004, Japan
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16
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Sugiyama S, Iwai T, Mikami T, Maegawa J. Delayed Infection of an Autopolymerising Acrylic Resin Implanted for Orbital Floor Reconstruction. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/46331.14395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Kobayashi S, Fukawa T, Yabuki Y, Satake T, Maegawa J. Le fort II distraction osteogenesis with a hybrid system for an Apert syndrome patient: A case report. JPRAS Open 2020; 27:34-39. [PMID: 33313372 PMCID: PMC7721690 DOI: 10.1016/j.jpra.2020.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 10/28/2020] [Indexed: 11/03/2022] Open
Abstract
Background Le Fort II advancement is considered for normalizing the facial appearance in Apert syndrome. When these procedures are performed during growth, overcorrection of midface advancement is required. We developed a system that can control the distance and vector of movement for the central midface to create more normal facial proportions. This case report shows Le Fort II distraction osteogenesis with this hybrid system for an Apert syndrome patient. Case The patient was a girl with Apert syndrome with midfacial-nose hypoplasia and skeletal class III malocclusion. She was healthy without respiratory problems and had no learning disabilities. She underwent our Le Fort II distraction osteogenesis with the hybrid system at 10 years and 6 months of age. Her midface was elongated 22 mm at point Or forward and moved 5° downward to the Frankfort horizontal plane compared to the standard position of average Japanese adult women on the cephalogram. Examining the facial image, the midfacial depression was improved 4 years after the operation. Discussion Overcorrection of midface advancement is required for patients to reduce the number of procedures during growth. The system that we developed could control the distance and vector of movement steadily when the central midface was overcorrected to try to create normal adult facial proportions.
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Affiliation(s)
- Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center Japan
| | | | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center Japan.,Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital Japan
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18
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Yabuki Y, Maegawa J, Shibukawa N, Kagimoto S, Kitayama S, Matsubara S, Mikami T. A Novel Approach to Subcutaneous Collecting Lymph Ducts Using a Small Diameter Wire in Animal Experiments and Clinical Trials. Lymphat Res Biol 2020; 19:73-79. [PMID: 32721266 DOI: 10.1089/lrb.2019.0047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: While performing microsurgery, including lymphaticovenous anastomosis (LVA) for chronic limb lymphedema, it is a common procedure to identify the subcutaneous collecting lymph ducts with near-infrared fluorescence lymphangiography (NIR) using indocyanine green. However, due to limitations such as minimum observable depth, only a few lymphatic ducts can be identified with this procedure. Hence, we developed a new smaller-diameter "lymphatic wire" (LW) that could be inserted directly into lymphatic collecting ducts of the limbs, enabling accurate identification and localization. Methods and Results: First, used the LW on the hind limbs of 6 swine, and 36 porcine lymphatic collecting ducts were identified, the outer diameter of which varied from 0.3-0.7 mm (mean 0.41 ± 0.11 mm). We could insert the LW after creating a side opening in 30 of these ducts. We encountered no difficulties during the procedure. In the pathological examination, adverse events such as valve dysfunction and perforation were not identified. Based on the results, a clinical evaluation of the LW was performed in two patients with lower extremity lymphedema, and the LW helped us identify lymphatic ducts in the subcutaneous layer, even at the sites where the NIR had proved ineffective. Conclusion: Based on our results, we suggest that the procedure for identifying lymphatic vessels using the newly developed LW is a useful technique that can be utilized before performing a LVA for lymphedema. However, further clinical study is required to develop this device and technique, for wider clinical application in the future.
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Affiliation(s)
- Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Naohiko Shibukawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Shintaro Kagimoto
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Shinya Kitayama
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Shinobu Matsubara
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Taro Mikami
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
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19
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Sugiyama S, Iwai T, Mikami T, Hibiya T, Maegawa J. Endoscopically Assisted Resection of a Cervical Multicystic Lymphatic Malformation in an Adult. Ear Nose Throat J 2020; 100:1076S-1078S. [PMID: 32579389 DOI: 10.1177/0145561320935838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Satomi Sugiyama
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Pathology, Yokohama, Kanagawa, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Pathology, Yokohama, Kanagawa, Japan
| | - Taro Mikami
- Department of Plastic and Reconstructive Surgery, Chigasaki Municipal Hospital, Chigasaki, Kanagawa, Japan
| | - Takashi Hibiya
- Department of Pathology Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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20
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Akita S, Unno N, Maegawa J, Kimata Y, Fukamizu H, Yabuki Y, Shinaoka A, Sano M, Kawasaki Y, Fujiwara T, Hanaoka H, Mitsukawa N. HAMAMATSU-ICG study: Protocol for a phase III, multicentre, single-arm study to assess the usefulness of indocyanine green fluorescent lymphography in assessing secondary lymphoedema. Contemp Clin Trials Commun 2020; 19:100595. [PMID: 32617434 PMCID: PMC7322679 DOI: 10.1016/j.conctc.2020.100595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 06/07/2020] [Accepted: 06/14/2020] [Indexed: 11/06/2022] Open
Abstract
Introduction Secondary lymphoedema of the extremities is an important quality-of-life issue for patients who were treated for their malignancies. Indocyanine green (ICG) fluorescent lymphography may be helpful for assessing lymphoedema and for planning lymphaticovenular anastomosis (LVA). The objective of the present clinical trial is to confirm whether or not ICG fluorescent lymphography using the near-infrared monitoring camera is useful for assessing the indication for LVA, for the identification of the lymphatic vessels before the conduct of LVA, and for the confirmation of the patency of the anastomosis site during surgery. Methods and analysis This trial is a phase III, multicentre, single-arm, open-label clinical trial to assess the efficacy and safety of ICG fluorescent lymphography when assessing and treating lymphoedema of patients with secondary lymphoedema who are under consideration for LVA. The primary endpoint is the identification rate of the lymphatic vessels at the incision site based on ICG fluorescent lymphograms obtained before surgery. The secondary endpoints are 1) the sensitivity and specificity of dermal back flow determined by ICG fluorescent lymphography as compared with 99mTc lymphoscintigraphy—one of the standard diagnostic methods and 2) the usefulness of ICG fluorescent lymphography when confirming the patency of the anastomosis site after LVA. Ethics and dissemination The protocol for the study was approved by the Institutional Review Board of each institution. The trial was filed for and registered at the Pharmaceuticals and Medical Devices Agency in Japan. The trial is currently on-going and is scheduled to end in June 2020. Trial registration number jRCT2031190064; Pre-results. This study will examine the efficacy of a highly safe drug, indocyanine green for evaluating lymphatic anatomy. This is the first, multicentre, prospective, systematised clinical trial of Indocyanine green lymphography. The present clinical trial will not allow the assessment of the therapeutic efficacy of lymphaticovenular anastomosis.
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Affiliation(s)
- Shinsuke Akita
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Naoki Unno
- Department of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Hidekazu Fukamizu
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Akira Shinaoka
- Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Masaki Sano
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yohei Kawasaki
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Tadami Fujiwara
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Hideki Hanaoka
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Nobuyuki Mitsukawa
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
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21
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Kobayashi S, Ohashi Y, Fukushima R, Hirakawa T, Fukawa T, Satake T, Maegawa J. Treatment of congenital short palate using bilateral buccal musculomucosal flaps. Case Reports Plast Surg Hand Surg 2020; 7:57-62. [PMID: 32490036 PMCID: PMC7241469 DOI: 10.1080/23320885.2020.1756821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 04/14/2020] [Indexed: 11/30/2022]
Abstract
A case of congenital short palate was treated by bilateral buccal musculomucosal flaps. The levator veli palatini muscle formed a continuous sling, but the anterior portion was attached to the posterior border of the hard palate. The speech outcome improved from severe to normal.
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Affiliation(s)
- Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yukie Ohashi
- Department of Speech treatment, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Ryouko Fukushima
- Department of Speech treatment, Kanagawa Children's Medical Center, Yokohama, Japan
| | | | | | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan
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Muto M, Satake T, Masuda Y, Kobayashi S, Tamura S, Kobayashi S, Ohtake T, Maegawa J. Absent Internal Mammary Recipient Vein in Autologous Breast Reconstruction. Plast Reconstr Surg Glob Open 2020; 8:e2660. [PMID: 32309101 PMCID: PMC7159964 DOI: 10.1097/gox.0000000000002660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/17/2019] [Indexed: 11/25/2022]
Abstract
The internal mammary vessels (IMA/Vs) have been used as the first-choice recipient vessels for microsurgical anastomosis and flap inset in autologous breast reconstruction owing to their ease of access and use compared with the thoracodorsal vessels (TDA/Vs). Herein, we report two cases of deep inferior epigastric perforator flap breast reconstructions in which the recipient internal mammary vein (IMV) was lacking. In the first case, a 50-year-old patient underwent delayed two-stage reconstruction, and in the second, a 45-year-old patient underwent delayed reconstruction because of capsular contracture following breast implant reconstruction. Neither patient received preoperative radiation therapy. During IMA/V preparation, we could not find the internal mammary vein (IMV) around the internal mammary artery (IMA) despite careful dissection. No internal mammary lymph node adenopathy and vascular encasement from metastasis were noted. Intraoperative indocyanine green angiography revealed absence of IMV, which was presumed to be congenital. Therefore, microsurgical anastomosis was performed to connect the deep inferior epigastric vessels to the thoracodorsal vessel. The postoperative course was uneventful in both cases. Although many anatomical studies have revealed different locations, diameters, branching patterns, and perforators of the IMA/V, absent IMV has been reported very rarely. In autologous breast reconstruction, plastic surgeons should be prepared for the possibility of the absence of IMV.
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Affiliation(s)
- Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Yuma Masuda
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Saya Kobayashi
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shihoko Tamura
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Tohru Ohtake
- Department of Breast Surgery, Fukushima Medical University Hospital, Fukushima, Fukushima, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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Asano S, Mikami T, Matsubara S, Maegawa J, Wakui H, Tamura K, Yoshimi R. Preliminary Report: The Relevance of Tumor Necrosis Factor-α in Acquired Primary Lymphedema-A Histopathological Investigation. Lymphat Res Biol 2019; 18:232-238. [PMID: 31750769 DOI: 10.1089/lrb.2019.0046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Lymphedema includes primary lymphedema (P-LE) and secondary lymphedema (S-LE), which is a chronic progressive disease. The former group is further classified as congenital and acquired P-LE (AP-LE); its etiology is unclear, and only a few studies on its pathophysiology exist. We hypothesized that an autoimmune disease or self-inflammatory mechanism occurs in lymphatic vessels, leading to obstruction. Methods and Results: We enrolled 46 patients with lymphedema who underwent lymphaticovenous anastomosis (LVA) from January to October 2015. Collecting lymph ducts were obtained during LVA. We performed hematoxylin/eosin staining and immunostaining for LYVE-1, IL-1β, IL-6, and TNF-α. There were no substantial histological differences between the two types of lymphedema, whereas some differences in expression of inflammatory cytokines, including interleukin (IL)-1β and tumor necrosis factor (TNF)-α, were observed. Only a few inflammatory cells could be seen around the vessels. Although no significant differences in expression of IL-1β were found between AP-LE and S-LE, TNF-α was more highly expressed in the smooth muscle layer in AP-LE patients than in S-LE patients. There were no significant morphological differences in the collecting ducts of lymphatic vessels between S-LE and P-LE. Nevertheless, higher levels of TNF-α accumulation were found in the thick smooth muscle layer of P-LE patients than in that of S-LE patients. Conclusion: TNF-α-related inflammation in collecting ducts of lymphatic vessels is an important characteristic of the pathology of P-LE. TNF-α inhibitors might improve symptoms of AP-LE.
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Affiliation(s)
- Saori Asano
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Taro Mikami
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shinobu Matsubara
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiromichi Wakui
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Kobayashi S, Yasumura K, Hirakawa T, Fukawa T, Maegawa J. Evaluation of Congenital Maxillary Growth Using Computed Tomography in Patients With Bilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2019; 57:282-287. [PMID: 31522540 DOI: 10.1177/1055665619874979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To analyze congenital lateral maxillary growth for patients with bilateral cleft lip and palate (BCLP). DESIGN A retrospective study. SETTING Kanagawa Children's Medical Center. MATERIALS Images from computed tomography (CT) of patients with BCLP and control patients that were previously used for treatment. MAIN OUTCOME MEASURES The following landmarks were used: A, the posterior most point of the piriform aperture; B, the superior most point of the acoustic meatus; C, the point at which line A-B intersects the line drawn perpendicular from line A-B to the maxillary tuberosity; and D, the apical most point of the nasal bone. The following distances were then measured using these landmarks: (1) A-B distance; (2) A-C distance; (3) A-C/A-B; (4) the angle between lines A-B and A-D (∠BAD); and (5) B-D distance. RESULT Mean A-B and A-C distances and A-C/A-B were significantly smaller in the BCLP group than in the control group (P < .01 each). Mean ∠BAD was significantly larger in the BCLP group than in the control group (P < .01). Mean B-D distance did not differ significantly between groups. CONCLUSIONS Our results indicated that the lateral maxillary segments of patients with BCLP were more posterior than those of the control group, and segment length was shorter compared to the control group on 3D-CT analysis. The lateral maxillary segments of patients with BCLP were basically suggested to originally be underdeveloped.
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Affiliation(s)
- Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Kazunori Yasumura
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | | | | | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan
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Mikami T, Koyama A, Hashimoto K, Maegawa J, Yabuki Y, Kagimoto S, Kitayama S, Kaneta T, Yasumura K, Matsubara S, Iwai T. Pathological changes in the lymphatic system of patients with secondary upper limb lymphoedema. Sci Rep 2019; 9:8499. [PMID: 31186436 PMCID: PMC6560042 DOI: 10.1038/s41598-019-44735-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 05/23/2019] [Indexed: 11/09/2022] Open
Abstract
Secondary upper limb lymphoedema is usually caused by lymphatic system dysfunction. Diagnosis is primarily based on clinical features. However, there are no distinct diagnostic criteria for lymphoedema. Although conventional lymphoscintigraphy is a useful technique to diagnose the severity of lymphoedema, the resultant data are two-dimensional. In this study, we examined the pathology of lymphoedema using single photon emission computed tomography-computed tomography lymphoscintigraphy (SPECT-CT LSG), a new technique that provides 3-dimensional information on lymph flow. We observed lymph flow pathways in the subcutaneous and muscle layers of the upper limbs. A significant positive correlation was found between the dermal back flow (DBF) type and the visualization of lymph nodes around the clavicle (p = 0.000266), the type of lymph flow pathways and the visualization of lymph nodes around the clavicle (p = 0.00963), and the DBF type and the lymph flow pathway (p = 0.00766). As the severity of lymphoedema increased, the DBF appeared more distally in the upper limb and the flow into the lymph nodes around the clavicle decreased, whereas the lymph flow pathways in the muscle layer became dominant. These findings demonstrate the features of lymphoedema pathology and the functional anatomy and physiology of the lymphatic system without the need for cadaver dissection.
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Affiliation(s)
- Taro Mikami
- Department of Plastic and Reconstructive Surgery, Yokohama City University, School of Medicine, Yokohama, Japan.
| | | | - Koukichi Hashimoto
- Department of Plastic and Reconstructive Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Shintaro Kagimoto
- Department of Plastic and Reconstructive Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Shinya Kitayama
- Department of Plastic and Reconstructive Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Tomohiro Kaneta
- Department of Radiology, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Kazunori Yasumura
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Shinobu Matsubara
- Department of Vascular Surgery, Yokohama Minami Kyousai Hospital, Yokohama, Japan
| | - Toshinori Iwai
- Department of Maxillofacial Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
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Satake T, Muto M, Kou S, Sugawara J, Narui K, Kobayashi S, Ishikawa T, Maegawa J. Bilateral breast reconstruction and pectus excavatum correction: a case and review of the literature. Eur J Plast Surg 2019. [DOI: 10.1007/s00238-018-1449-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kokubo K, Katori N, Hayashi K, Sugawara J, Kou S, Fujii A, Kitamura S, Ninomiya R, Maegawa J. Evaluation of the eyebrow position after aponeurosis advancement. J Plast Surg Hand Surg 2019; 53:60-64. [PMID: 30676851 DOI: 10.1080/2000656x.2018.1547735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Patients often develop eyebrow drooping after blepharoplasty or ptosis repair. After aponeurosis advancement was performed in 53 patients (100 eyelids) with blepharoptosis, the eyebrow heights at the medial canthus, center of the pupil, and lateral canthus were measured using scanned photographs obtained preoperatively and 3 months postoperatively. In the 100 eyelids subjected to aponeurosis advancement, the eyebrow position was lowered at the medial canthus in 81 eyelids (81%), at the center of the pupil in 84 eyelids (84%), and at the lateral canthus in 80 eyelids (80%). The mean distance of eyebrow drooping in the 100 eyelids was 2.80 mm at the medial canthus, 2.87 mm at the center of the pupil, and 2.50 mm at the lateral canthus. The preoperative margin reflex distance (MRD) was significantly associated with the distance of eyebrow drooping at the medial canthus, the center of the pupil, and the lateral canthus in the 100 eyelids, but the postoperative MRD was not significantly associated with these parameters in the 100 eyelids. In conclusion, eyebrow drooping developed after aponeurosis advancement in most cases, and the distance of eyebrow drooping was associated with the severity of blepharoptosis.
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Affiliation(s)
- Kenichi Kokubo
- a Department of Plastic Surgery , Fujisawa Shounandai Hospital , Fujisawa-shi , Kanagawa , Japan
| | - Nobutada Katori
- b Department of Ocular Plastic & Orbital Surgery , Seirei Hamamatsu General Hospital , Hamamatsu-shi , Shizuoka , Japan
| | - Kengo Hayashi
- c Yokohama Sakuragicho Eye Clinic , Yokohama-shi , Kanagawa , Japan
| | | | - Seiko Kou
- e KO CLINIC for Antiaging , Yokohama-shi , Kanagawa , Japan
| | - Akiko Fujii
- f Department of Plastic and Reconstructive Surgery , Yokohama City University Hospital , Yokohama-shi , Kanagawa , Japan
| | - Syou Kitamura
- f Department of Plastic and Reconstructive Surgery , Yokohama City University Hospital , Yokohama-shi , Kanagawa , Japan
| | - Ryunosuke Ninomiya
- f Department of Plastic and Reconstructive Surgery , Yokohama City University Hospital , Yokohama-shi , Kanagawa , Japan
| | - Jiro Maegawa
- f Department of Plastic and Reconstructive Surgery , Yokohama City University Hospital , Yokohama-shi , Kanagawa , Japan
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Mikami T, Kaida E, Yabuki Y, Kitamura S, Kokubo K, Maegawa J. Negative Pressure Wound Therapy Followed by Basic Fibroblast Growth Factor Spray as a Recovery Technique in Partial Necrosis of Distally Based Sural Flap for Calcaneal Osteomyelitis: A Case Report. J Foot Ankle Surg 2018; 57:816-820. [PMID: 29605553 DOI: 10.1053/j.jfas.2017.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Indexed: 02/03/2023]
Abstract
The distally based sural flap is regarded as the first choice for reconstruction in the distal part of the lower leg because the flap is easy to raise, reliable in its blood supply, and prone to only a few complications. Limited data have investigated the details of treatment in cases of failure of distally based sural flaps. We report a case of calcaneal osteomyelitis in which a successful outcome was finally obtained with a partially necrosed, distally based sural flap using negative pressure wound therapy with basic fibroblast growth factor spray. The 2-year follow-up examination was uneventful. Moreover, the patient was able to walk freely with an ankle-foot orthosis in her house. This technique can be considered as a useful and effective option to recover unfavorable results of distally based sural flaps.
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Affiliation(s)
- Taro Mikami
- Plastic and Reconstructive Surgeon, Department of Plastic and Reconstructive Surgery, Fujisawa Shounandi Hospital, Fujisawa, Kanagawa-ken, Japan; Associate Professor and Plastic and Reconstructive Surgeon, Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa-ken, Japan.
| | - Eriko Kaida
- Plastic and Reconstructive Surgeon, Department of Plastic and Reconstructive Surgery, Fujisawa Shounandi Hospital, Fujisawa, Kanagawa-ken, Japan
| | - Yuichiro Yabuki
- Assistant Professor and Plastic and Reconstructive Surgeon, Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa-ken, Japan
| | - Sho Kitamura
- Plastic and Reconstructive Surgeon, Department of Plastic and Reconstructive Surgery, Fujisawa Shounandi Hospital, Fujisawa, Kanagawa-ken, Japan
| | - Ken'ichi Kokubo
- Plastic and Reconstructive Surgeon, Department of Plastic and Reconstructive Surgery, Fujisawa Shounandi Hospital, Fujisawa, Kanagawa-ken, Japan
| | - Jiro Maegawa
- Professor and Plastic and Reconstructive Surgeon, Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa-ken, Japan
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Homma Y, Satake T, Narui K, Tamanoi Y, Muto M, Komiya T, Kobayashi S, Ishikawa T, Maegawa J. Salvage mastectomy for local recurrence and second ipsilateral autologous breast reconstruction using a perforator flap from a different donor site. Case Reports Plast Surg Hand Surg 2018; 5:54-58. [PMID: 30276223 PMCID: PMC6161600 DOI: 10.1080/23320885.2018.1515020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/20/2018] [Indexed: 10/30/2022]
Abstract
Only one case of second ipsilateral autologous reconstruction for the same breast that had previously undergone reconstruction has been reported. Here we present a patient who underwent breast reconstruction twice using free flap from different donor sites, using a buttock after a local recurrence following the previous reconstruction with a lower abdomen.
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Affiliation(s)
- Yuki Homma
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Yoshihiko Tamanoi
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Takako Komiya
- Department of Plastic and Reconstructive Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Takashi Ishikawa
- Department of Breast Oncology and Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan
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Satake T, Muto M, Nagashima Y, Haga S, Homma Y, Nakasone R, Kadokura M, Kou S, Fujimoto H, Maegawa J. Polyurethane Foam Wound Dressing Technique for Areola Skin Graft Stabilization and Nipple Protection After Nipple-Areola Reconstruction. Aesthetic Plast Surg 2018; 42:442-446. [PMID: 29101435 DOI: 10.1007/s00266-017-1013-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 10/20/2017] [Indexed: 11/25/2022]
Abstract
We describe a new wound management technique using a soft dressing material to stabilize the areola skin graft and protect the nipple after nipple-areola reconstruction at the final stage of breast reconstruction. We introduced a center-fenestrated multilayered hydrocellular polyurethane foam dressing material that provides adequate pressure and retains a moist environment for a smooth skin graft "take." Moreover, the reconstructed nipple can be monitored at any time through the fenestrated window for adequate blood circulation. Altogether, this simple and inexpensive wound dressing technique improves the clinical outcome. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-56 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-56 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Yu Nagashima
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-56 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Shoko Haga
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-56 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Yuki Homma
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-56 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Reiko Nakasone
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-56 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Marina Kadokura
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-56 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Seiko Kou
- Department of Plastic and Aesthetic Surgery, KO Clinic for Antiaging, 4-54 Onoe-cho, Naka-ku, Yokohama, Kanagawa, 231-0015, Japan
| | - Hiroshi Fujimoto
- Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-0856, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Horie Y, Makihara H, Horikawa K, Takeshige F, Ibuki A, Satake T, Yasumura K, Maegawa J, Mitsui H, Ohashi K, Akase T. Reduced skin lipid content in obese Japanese women mediated by decreased expression of rate-limiting lipogenic enzymes. PLoS One 2018. [PMID: 29518109 PMCID: PMC5843255 DOI: 10.1371/journal.pone.0193830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Skin barrier function is often deficient in obese individuals, but the underlying molecular mechanisms remain unclear. This study investigated how skin structure and lipid metabolism, factors strongly associated with barrier function, differed among 50 Japanese women of greatly varying body mass index (BMI). Subjects receiving breast reconstruction surgery were chosen for analysis to obtain skin samples from the same site. The subjects were classified into two groups, control (BMI < 25 kg/m2) and obese (25 kg/m2 ≤ BMI < 35 kg/m2), according to standards in Japan. Hematoxylin and eosin staining was used to assess skin thickness, Ki-67 immunostaining to examine keratinocyte proliferation, and real-time polymerase chain reaction to measure skin expression levels of genes associated with lipid metabolism. Total lipids, cholesterol, and fatty acids were also measured from these same skin samples. In the obese group, structural changes included epidermal thickening and an increase in the number of Ki-67-positive (proliferating) cells. Both skin cholesterol and fatty acid levels exhibited an “inverted-U” relationship with BMI, suggesting that there is an optimal BMI for peak lipid content and barrier function. Decreased lipid levels at higher BMI were accompanied by downregulated expression of PPARδ and other genes related to lipid metabolism, including those encoding acetyl-CoA carboxylase and HMG-CoA reductase, the rate-limiting enzymes for fatty acid and cholesterol synthesis, respectively. Thus, elevated BMI may lead to deficient skin barrier function by suppressing local lipid synthesis.
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Affiliation(s)
- Yoshiko Horie
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Hiroko Makihara
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kazumasa Horikawa
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Fumika Takeshige
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Ai Ibuki
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Kazunori Yasumura
- Plastic and Reconstructive Surgery, Kanagawa Children’s Medical Center, Yokohama, Kanagawa, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Hideaki Mitsui
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kenichi Ohashi
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Tomoko Akase
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
- * E-mail:
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Daigo K, Takano A, Thang PM, Yoshitake Y, Shinohara M, Tohnai I, Murakami Y, Maegawa J, Daigo Y. Characterization of KIF11 as a novel prognostic biomarker and therapeutic target for oral cancer. Int J Oncol 2017; 52:155-165. [PMID: 29115586 PMCID: PMC5743338 DOI: 10.3892/ijo.2017.4181] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/21/2017] [Indexed: 11/16/2022] Open
Abstract
Oral cancer has a high mortality rate, and its incidence is increasing gradually worldwide. As the effectiveness of standard treatments is still limited, the development of new therapeutic strategies is eagerly awaited. Kinesin family member 11 (KIF11) is a motor protein required for establishing a bipolar spindle in cell division. The role of KIF11 in oral cancer is unclear. Therefore, the present study aimed to assess the role of KIF11 in oral cancer and evaluate its role as a prognostic biomarker and therapeutic target for treating oral cancer. Immunohistochemical analysis demonstrated that KIF11 was expressed in 64 of 99 (64.6%) oral cancer tissues but not in healthy oral epithelia. Strong KIF11 expression was significantly associated with poor prognosis among oral cancer patients (P=0.034), and multivariate analysis confirmed its independent prognostic value. In addition, inhibition of KIF11 expression by transfection of siRNAs into oral cancer cells or treatment of cells with a KIF11 inhibitor significantly suppressed cell proliferation, probably through G2/M arrest and subsequent induction of apoptosis. These results suggest that KIF11 could be a potential prognostic biomarker and therapeutic target for oral cancer.
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Affiliation(s)
- Kayo Daigo
- Center for Antibody and Vaccine Therapy, Research Hospital, Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| | - Atsushi Takano
- Center for Antibody and Vaccine Therapy, Research Hospital, Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| | - Phung Manh Thang
- Center for Antibody and Vaccine Therapy, Research Hospital, Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Yoshitake
- Department of Oral and Maxillofacial Surgery, Kumamoto University, Kumamoto, Japan
| | - Masanori Shinohara
- Department of Oral and Maxillofacial Surgery, Kumamoto University, Kumamoto, Japan
| | - Iwau Tohnai
- Department of Oral and Maxillofacial Surgery, Yokohama City University, Yokohama, Japan
| | - Yoshinori Murakami
- Division of Molecular Pathology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University, Yokohama, Japan
| | - Yataro Daigo
- Center for Antibody and Vaccine Therapy, Research Hospital, Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
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Mikami T, Kagimoto S, Yabuki Y, Yasumura K, Iwai T, Maegawa J, Suganuma N, Hirakawa S, Masudo K. Deltopectoral flap revisited for reconstruction surgery in patients with advanced thyroid cancer: a case report. BMC Surg 2017; 17:101. [PMID: 28915833 PMCID: PMC5603086 DOI: 10.1186/s12893-017-0297-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 09/05/2017] [Indexed: 12/04/2022] Open
Abstract
Background We present the cases of 2 patients with invasive thyroid cancer, who underwent reconstructive surgery using a deltopectoral flap. Although the overall rate of extrathyroidal extension in patients with thyroid cancer is quite low, skin invasion is the most common pattern observed. Reconstructive surgery, involving local skin flaps, is required in these patients. The deltopectoral flap relies on the blood supply from intercostal perforators of the internal thoracic artery and usually requires skin grafting to the donor site. The internal thoracic artery is rarely sacrificed in these cases, even in an advanced surgery such as in patients with invasive thyroid cancer. Case presentation A 55-year-old man with a distended thyroid gland presented to our hospital. He underwent advanced surgery, including skin excision, because we suspected that his tumor was thyroid cancer. The defect was covered with an ipsilateral deltopectoral flap via transposition of the flap, without skin grafting. In the second case, a 67-year-old woman with thyroid cancer that metastasized to her neck lymph nodes presented to our institution. Although the ipsilateral internal thoracic artery was sacrificed near its origin during tumor resection, the deltopectoral flap was raised in the usual manner without any complications. The skin defect caused by the tumor resection was covered with the flap. The patient had an uneventful clinical course for more than 2 years of follow-up. These 2 cases show the effectiveness of using the deltopectoral flap as a reconstructive option for patients with thyroid cancer who underwent radical surgery, resulting in a skin defect. The first case shows that this flap does not always require skin grafting to the donor site. To our knowledge, the second case may be the first report of a deltopectoral flap that was safely raised and applied with resection of the bifurcation of the ipsilateral internal thoracic artery. Conclusions Although thyroid cancer surgery with surrounding skin excision is a rare procedure, we found that the deltopectoral flap was useful and should be the first choice for patients undergoing reconstructive surgery, whether the bifurcation of the ipsilateral internal thoracic artery is sacrificed. Electronic supplementary material The online version of this article (10.1186/s12893-017-0297-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Taro Mikami
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 236-0004 Kanazawa-ku, Yokohama city, Kanagawa prefecture, Japan.
| | - Shintaro Kagimoto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 236-0004 Kanazawa-ku, Yokohama city, Kanagawa prefecture, Japan
| | - Yuichiro Yabuki
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 236-0004 Kanazawa-ku, Yokohama city, Kanagawa prefecture, Japan
| | - Kazunori Yasumura
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 236-0004 Kanazawa-ku, Yokohama city, Kanagawa prefecture, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 236-0004 Kanazawa-ku, Yokohama city, Kanagawa prefecture, Japan
| | - Nobuyasu Suganuma
- Department of General Surgery, Yokohama City University Hospital, Yokohama, Japan
| | - Shohei Hirakawa
- Department of General Surgery, Yokohama City University Hospital, Yokohama, Japan
| | - Katsuhiko Masudo
- Department of General Surgery, Yokohama City University Hospital, Yokohama, Japan
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Kitayama S, Maegawa J, Matsubara S, Kobayashi S, Mikami T, Hirotomi K, Kagimoto S. Real-Time Direct Evidence of the Superficial Lymphatic Drainage Effect of Intermittent Pneumatic Compression Treatment for Lower Limb Lymphedema. Lymphat Res Biol 2017; 15:77-86. [DOI: 10.1089/lrb.2016.0031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shinya Kitayama
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shinobu Matsubara
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Taro Mikami
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Koichi Hirotomi
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shintaro Kagimoto
- Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine, Yokohama, Japan
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Shibuya M, Satake T, Nakasone R, Ogawa M, Muto M, Narui K, Yasumura K, Ishikawa T, Maegawa J. Erratum to: Breast reconstruction using free medial circumflex femoral artery perforator flaps: intraoperative anatomic study and clinical results. Breast Cancer 2016; 24:465. [PMID: 27896661 DOI: 10.1007/s12282-016-0745-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mai Shibuya
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Reiko Nakasone
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Marina Ogawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazunori Yasumura
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Takashi Ishikawa
- Department of Breast Oncology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.,Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Japan
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Kokubo K, Katori N, Hayashi K, Sugawara J, Fujii A, Maegawa J. Evaluation of the eyebrow position after levator resection. J Plast Reconstr Aesthet Surg 2016; 70:85-90. [PMID: 27773564 DOI: 10.1016/j.bjps.2016.09.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/26/2016] [Indexed: 11/25/2022]
Abstract
Although we commonly observe eyebrow drooping during and after blepharoptosis surgery, it may not occur in some cases. After levator resection was performed in 47 patients (84 eyelids) with blepharoptosis, the eyebrow heights at the medial canthus, the center of the pupil, and the lateral canthus were measured using scanned photographs obtained preoperatively and 3 months postoperatively. In the 84 eyelids, after levator resection, the eyebrow position was lowered at the medial canthus in 76 patients (90%), at the center of the pupil in 75 (89%), and at the lateral canthus in 76 (90%). The mean distance of eyebrow drooping in the 84 pupils was 2.74 mm at the medial canthus, 2.91 mm at the center of the pupil, and 2.58 mm at the lateral canthus. In addition, there was a significant difference between the extra skin excision group and the no skin excision group at the medial canthus (p = 0.027), the center of the pupil (p = 0.001), and the lateral canthus (p < 0.001) (Mann-Whitney test). Unfortunately, there was a significant difference in ages between the extra skin excision group and the no skin excision group. In conclusion, eyebrow drooping was caused after levator resection in most cases. However, it is difficult to anticipate eyebrow drooping distance before surgery.
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Affiliation(s)
- Kenichi Kokubo
- Department of Plastic Surgery, Fujisawa Shounandai Hospital, 2345 Takakura, Fujisawa-shi, Kanagawa 251-0802, Japan.
| | - Nobutada Katori
- Department of Ocular Plastic & Orbital Surgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-shi, Shizuoka 430-8558, Japan
| | - Kengo Hayashi
- Yokohama Sakuragicho Eye Clinic, 1-200 Hinodecho, Naka-ku, Yokohama-shi, Kanagawa 231-0006, Japan
| | - Jun Sugawara
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Akiko Fujii
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
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Matsuyama R, Mori R, Ota Y, Homma Y, Kumamoto T, Takeda K, Morioka D, Maegawa J, Endo I. Significance of Vascular Resection and Reconstruction in Surgery for Hilar Cholangiocarcinoma: With Special Reference to Hepatic Arterial Resection and Reconstruction. Ann Surg Oncol 2016; 23:475-484. [PMID: 27387681 DOI: 10.1245/s10434-016-5381-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE The aim of this study was to assess the efficacy of combined resection and reconstruction (CRR) of the hepatic artery (HA) in surgery for hilar cholangiocarcinoma (HC). MATERIALS AND METHOD Among 172 patients who underwent surgical resection for HC, the following three groups were defined according to the type of vascular reconstruction: VR(-) group, in which neither CRR of the portal vein (PV) nor HA was performed (n = 74); VR-PV group, in which only CRR of the PV was required (n = 54); and VR-A group, in which CRR of the HA was performed either with or without CRR of the PV (n = 44). Clinicopathological variables and clinical outcomes were compared among the three groups. RESULTS Although the VR-A group showed significantly more advanced disease than other groups, the R0 resection rate was comparable among the three groups (VR(-), 74 %; VR-PV, 80 %; VR-A, 80 %). The 5-year disease-specific survival rate was also comparable among the three groups (VR(-), 45.6 %; VR-PV, 51.2 %; VR-A, 22.3 %), but tended to be worse in the VR-A group than in the other groups. A similar trend was observed in morbidity rate. Lymph node metastasis was more frequent in the VR-A group (59 %) than in the other groups (VR(-), 33.8 %; VR-PV, 50 %). In the VR-A group, lymph node metastasis (p = 0.004) and adjuvant chemotherapy (p = 0.006) were determined to represent independent prognostic factors for survival according to multivariate analysis. CONCLUSION CRR of the HA was considered efficacious in selected patients; however, long-term outcomes of the VR-A group seem unsatisfactory. Treatments additional to surgery may be necessary in cases requiring CRR of the HA.
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Affiliation(s)
- Ryusei Matsuyama
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Ryutaro Mori
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yohei Ota
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yuki Homma
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takafumi Kumamoto
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuhisa Takeda
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Daisuke Morioka
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Jiro Maegawa
- Department of Plastic Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Satake T, Nakasone R, Kobayashi S, Maegawa J. Immediate breast reconstruction using the free lumbar artery perforator flap and lateral thoracic vein interposition graft for recipient lateral thoracic artery anastomosis. Indian J Plast Surg 2016; 49:91-4. [PMID: 27274129 PMCID: PMC4878252 DOI: 10.4103/0970-0358.182248] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The lumbar artery perforator (LAP) flap, which contains excess skin and fat tissue, love handles, that extends from the lower back to upper buttock, may provide an alternate tissue source for autologous breast reconstruction. However, LAP flap use during this procedure frequently requires vessel interposition grafts to correct the short flap pedicle length and mismatched recipient vessel calibre. A 46-year-old patient underwent a right nipple-sparing mastectomy using a lateral approach for ductal carcinoma in situ and immediate LAP flap breast reconstruction. The lateral thoracic vessel served as the recipient vessel, and a lateral thoracic vein interposition graft from the distal remnant was performed to adjust the arterial length and size discrepancy between the recipient lateral thoracic artery and pedicle artery. This procedure facilitates microsurgical anastomosis and medialisation of LAP flap to make a natural decollete line and create a cleavage for the reconstructed breast.
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Affiliation(s)
- Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Reiko Nakasone
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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Kitagawa M, Ninomiya R, Hirotomi K, Yamamoto Y, Kobayashi S, Sakakibara H, Maegawa J, Satake T. Simultaneous Total Laparoscopic Hysterectomy during Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction and Contralateral Superficial Inferior Epigastric Artery Flap Breast Augmentation. J Reconstr Microsurg Open 2016. [DOI: 10.1055/s-0036-1584220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Masakazu Kitagawa
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Ryunosuke Ninomiya
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Koichi Hirotomi
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Yasushi Yamamoto
- Department of Plastic and Reconstructive Surgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Shinji Kobayashi
- Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Hideya Sakakibara
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
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Kokubo K, Katori N, Hayashi K, Kasai K, Kamisasanuki T, Sueoka K, Maegawa J. Frontalis suspension with an expanded polytetrafluoroethylene sheet for congenital ptosis repair. J Plast Reconstr Aesthet Surg 2016; 69:673-8. [DOI: 10.1016/j.bjps.2016.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
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Satake T, Muto M, Yasuoka Y, Tamanoi Y, Hishikawa M, Sugawara J, Yasumura K, Kobayashi S, Maegawa J. Tertiary breast reconstruction using a free contralateral latissimus dorsi myocutaneous flap and contralateral internal mammary recipient vessel anastomosis. JPRAS Open 2016. [DOI: 10.1016/j.jpra.2015.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kagimoto S, Takebe T, Kobayashi S, Yabuki Y, Hori A, Hirotomi K, Mikami T, Uemura T, Maegawa J, Taniguchi H. Autotransplantation of Monkey Ear Perichondrium-Derived Progenitor Cells for Cartilage Reconstruction. Cell Transplant 2016; 25:951-62. [PMID: 26884211 DOI: 10.3727/096368916x690917] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We recently developed a promising regenerative method based on the xenotransplantation of human cartilage progenitor cells, demonstrating self-renewing elastic cartilage reconstruction with expected long-term tissue restoration. However, it remains unclear whether autotransplantation of cartilage progenitors may work by a similar principle in immunocompetent individuals. We used a nonhuman primate (monkey) model to assess the safety and efficacy of our regenerative approach because the model shares characteristics with humans in terms of biological functions, including anatomical features. First, we identified the expandable and multipotent progenitor population from monkey ear perichondrium and succeeded in inducing chondrocyte differentiation in vitro. Second, in vivo transplanted progenitor cells were capable of reconstructing elastic cartilage by xenotransplantation into an immunodeficient mouse. Finally, the autologous monkey progenitor cells were transplanted into the subcutaneous region of a craniofacial section and developed mature elastic cartilage of their own 3 months after transplantation. Furthermore, we attempted to develop a clinically relevant, noninvasive monitoring method using magnetic resonance imaging (MRI). Collectively, this report shows that the autologous transplantation of cartilage progenitors is potentially effective for reconstructing elastic cartilage. This principle will be invaluable for repairing craniofacial injuries and abnormalities in the context of plastic and reconstructive surgery.
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Affiliation(s)
- Shintaro Kagimoto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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Iwai T, Mikami T, Yasumura K, Tohnai I, Maegawa J. Use of Occlusal Splint for Noninvasive Fixation of a Reference Frame in Orbital Navigation Surgery. J Maxillofac Oral Surg 2015; 15:410-412. [PMID: 27752217 DOI: 10.1007/s12663-015-0860-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION When prepping for navigation surgery, a reference frame must be fixed to the patient's head with a Mayfield clamp, bone anchor, headset, or headband. Fixation of the clamp or bone anchor with a screw or head pins is invasive, whereas use of a headband or headset is noninvasive. However, during orbital surgery for blowout fractures or orbital tumors, surgeons or instruments can interfere between the reference frame and the optical tracking navigation system, even if using noninvasive fixation. MATERIALS AND METHODS We used an occlusal splint for noninvasive fixation of a reference frame in orbital navigation surgery to overcome the problems. RESULTS A surgeon could operate without interferences between the reference frame and the optical tracking navigation system during orbital navigation surgery. CONCLUSION We recommend the use of an occlusal splint for noninvasive fixation of a reference frame in orbital navigation surgery.
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Affiliation(s)
- Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| | - Taro Mikami
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| | - Kazunori Yasumura
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, 232-0024 Japan
| | - Iwai Tohnai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
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Sugawara J, Satake T, Muto M, Kou S, Yasumura K, Maegawa J. Dynamic blood flow to the retrograde limb of the internal mammary vein in breast reconstruction with free flap. Microsurgery 2015; 35:622-6. [DOI: 10.1002/micr.22500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 08/27/2015] [Accepted: 09/01/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Jun Sugawara
- Department of Plastic and Reconstructive Surgery; Yokohama City University; Yokohama Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery; Yokohama City University Medical Center; Yokohama Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery; Yokohama City University Medical Center; Yokohama Japan
| | - Seiko Kou
- KO CLINIC For Antiaging; Yokohama Japan
| | - Kazunori Yasumura
- Department of Plastic and Reconstructive Surgery; Yokohama City University Medical Center; Yokohama Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery; Yokohama City University; Yokohama Japan
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Sugawara J, Kou S, Kou S, Yasumura K, Satake T, Maegawa J. Influence of the frequency of laser toning for melasma on occurrence of leukoderma and its early detection by ultraviolet imaging. Lasers Surg Med 2015; 47:161-7. [DOI: 10.1002/lsm.22325] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Jun Sugawara
- Department of plastic and Reconstructive Surgery,; Yokohama City University Medical Center; Yokohama Japan
| | - Seiko Kou
- KO CLINIC for Antiaging; Yokohama Japan
| | - Sousei Kou
- Ko Ladies Clinic Enoshima; Fujisawa Japan
| | - Kazunori Yasumura
- Department of plastic and Reconstructive Surgery,; Yokohama City University Medical Center; Yokohama Japan
| | - Toshihiko Satake
- Department of plastic and Reconstructive Surgery,; Yokohama City University Medical Center; Yokohama Japan
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Mizuno M, Kobayashi S, Takebe T, Kan H, Yabuki Y, Matsuzaki T, Yoshikawa HY, Nakabayashi S, Ik LJ, Maegawa J, Taniguchi H. Brief report: reconstruction of joint hyaline cartilage by autologous progenitor cells derived from ear elastic cartilage. Stem Cells 2014; 32:816-21. [PMID: 24038678 DOI: 10.1002/stem.1529] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 08/05/2013] [Indexed: 12/29/2022]
Abstract
In healthy joints, hyaline cartilage covering the joint surfaces of bones provides cushioning due to its unique mechanical properties. However, because of its limited regenerative capacity, age- and sports-related injuries to this tissue may lead to degenerative arthropathies, prompting researchers to investigate a variety of cell sources. We recently succeeded in isolating human cartilage progenitor cells from ear elastic cartilage. Human cartilage progenitor cells have high chondrogenic and proliferative potential to form elastic cartilage with long-term tissue maintenance. However, it is unknown whether ear-derived cartilage progenitor cells can be used to reconstruct hyaline cartilage, which has different mechanical and histological properties from elastic cartilage. In our efforts to develop foundational technologies for joint hyaline cartilage repair and reconstruction, we conducted this study to obtain an answer to this question. We created an experimental canine model of knee joint cartilage damage, transplanted ear-derived autologous cartilage progenitor cells. The reconstructed cartilage was rich in proteoglycans and showed unique histological characteristics similar to joint hyaline cartilage. In addition, mechanical properties of the reconstructed tissues were higher than those of ear cartilage and equal to those of joint hyaline cartilage. This study suggested that joint hyaline cartilage was reconstructed from ear-derived cartilage progenitor cells. It also demonstrated that ear-derived cartilage progenitor cells, which can be harvested by a minimally invasive method, would be useful for reconstructing joint hyaline cartilage in patients with degenerative arthropathies.
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Affiliation(s)
- Mitsuru Mizuno
- Department of Regenerative Medicine, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
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Takebe T, Kobayashi S, Suzuki H, Mizuno M, Chang YM, Yoshizawa E, Kimura M, Hori A, Asano J, Maegawa J, Taniguchi H. Transient vascularization of transplanted human adult-derived progenitors promotes self-organizing cartilage. J Clin Invest 2014; 124:4325-34. [PMID: 25202983 DOI: 10.1172/jci76443] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 08/07/2014] [Indexed: 01/13/2023] Open
Abstract
Millions of patients worldwide are affected by craniofacial deformations caused by congenital defects or trauma. Current surgical interventions have limited therapeutic outcomes; therefore, methods that would allow cartilage restoration are of great interest. A number of studies on embryonic limb development have shown that chondrogenesis is initiated by cellular condensation, during which mesenchymal progenitors aggregate and form 3D structures. Here, we demonstrated efficient regeneration of avascular elastic cartilage from in vitro-grown mesenchymal condensation, which recapitulated the early stages of chondrogenesis, including transient vascularization. After transplantation of vascularized condensed progenitors into immunodeficient mice, we used an intravital imaging approach to follow cartilage maturation. We determined that endothelial cells are present inside rudimentary cartilage (mesenchymal condensation) prior to cartilage maturation. Recreation of endothelial interactions in culture enabled a recently identified population of adult elastic cartilage progenitors to generate mesenchymal condensation in a self-driven manner, without requiring the support of exogenous inductive factors or scaffold materials. Moreover, the culture-grown 3D condensed adult-derived progenitors were amenable to storage via simple freezing methods and efficiently reconstructed 3D elastic cartilage upon transplantation. Together, our results indicate that transplantation of endothelialized and condensed progenitors represents a promising approach to realizing a regenerative medicine treatment for craniofacial deformations.
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Oshiro H, Fukumura H, Nagahama K, Sato I, Sugiura K, Iobe H, Okiyama E, Nagao T, Nagashima Y, Aoki I, Yamanaka S, Murakami A, Maegawa J, Chishima T, Ichikawa Y, Ishikawa Y, Nagai T, Nomura M, Ohashi K, Okudela K. Establishment of successively transplantable rabbit VX2 cancer cells that express enhanced green fluorescent protein. Med Mol Morphol 2014; 48:13-23. [PMID: 24573404 DOI: 10.1007/s00795-014-0071-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/15/2014] [Indexed: 11/26/2022]
Abstract
Morphological detection of cancer cells in the rabbit VX2 allograft transplantation model is often difficult in a certain region such as serosal cavity where reactive mesothelial cells mimic cancer cells and both cells share common markers such as cytokeratins. Therefore, tagging VX2 cells with a specific and sensitive marker that easily distinguishes them from other cells would be advantageous. Thus, we tried to establish a successively transplantable, enhanced green fluorescent protein (EGFP)-expressing VX2 model. Cancer cells obtained from a conventional VX2-bearing rabbit were cultured in vitro and transfected with an EGFP-encoding vector, and then successively transplanted in Healthy Japanese White rabbits (HJWRs) (n = 8). Besides, conventional VX2 cells were transplanted in other HJWRs (n = 8). Clinicopathological comparison analyses were performed between the two groups. The success rate of transplantation was 100% for both groups. The sensitivity and specificity of EGFP for immunohistochemical detection of VX2 cells were 84.3 and 100%, respectively. No significant differences in cancer cell morphology, tumor size (P = 0.742), Ki-67 labeling index (P = 0.878), or survival rate (P = 0.592) were observed between the two. VX2 cells can be genetically altered, visualized by EGFP, and successively transplanted without significant alteration of morphological and biological properties compared to those of the conventional model.
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Affiliation(s)
- Hisashi Oshiro
- Department of Pathology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan,
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Iwai T, Maegawa J, Aoki S, Tohnai I. Ultrasonic vertical osteotomy of the distal segment for safe elimination of interference between the proximal and distal segments in bilateral sagittal split osteotomy for mandibular asymmetry. Br J Oral Maxillofac Surg 2013; 51:e192-4. [DOI: 10.1016/j.bjoms.2012.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 05/28/2012] [Indexed: 11/30/2022]
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