記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/PRS.0000000000010428

PubMed

担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.18999/nagjms.85.1.7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1080/23320885.2022.2039667

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.7759/cureus.27209

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Microsurgery  

Background: Non-thrombotic skin paddle necrosis occasionally occurs during mandibular reconstructions with free fibula osteocutaneous flaps. The number of perforators, size of the skin paddle, and ischemia time of the flap are considered as causes of skin paddle necrosis. The importance of donor side selection has also been highlighted. This study aimed to investigate the leading cause of skin paddle necrosis and the optimal reconstructive procedure. Methods: A total of 66 patients who underwent mandibular reconstruction using a free fibula osteocutaneous flap were retrospectively analyzed. Skin paddle necrosis, number of cutaneous perforators, size of the skin paddle, and ischemia time of the flap were investigated. An incorrect “laterality” was defined as a skin paddle (septum) covering the reconstruction plate. Donor-site morbidity was recorded. Results: Skin paddle necrosis occurred in 15.2% of patients. An incorrect laterality was associated with a higher incidence of skin paddle necrosis (odds ratio, 22.0; 95% confidence interval, 2.5–195; p =.005). Donor-site morbidity was noted in 18.8% of the patients, without any significant difference in terms of the donor side with and without skin graft (p =.592). The postoperative activities of daily living were not affected. Conclusions: To prevent skin paddle necrosis, donor side selection is an important safety strategy during mandibular reconstruction with free fibula osteocutaneous flap. The postoperative activities of daily living were found to be little affected by differences in the donor side.

DOI： 10.1002/micr.30881

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記述言語：英語  

DOI： 10.1016/j.anl.2021.10.013

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/SCS.0000000000008334

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Eplasty  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Laryngoscope Investigative Otolaryngology  

Purpose: To investigate the oncological outcomes of orbital malignant tumors invading the skull base. Methods: A retrospective analysis was conducted on 16 patients with orbital malignant tumors invading the skull base. Eleven patients were treated with skull base surgery, four patients were treated with particle therapies, and one patient was treated with chemoradiotherapy (CRT) as initial treatment. Results: The most frequent histological type was adenoid cystic carcinoma in seven patients, followed by squamous cell carcinoma in two patients. Local recurrence occurred in two of the six surgically treated patients who did not receive postoperative radiotherapy (RT) or CRT. One of them was successfully salvaged by RT, and the other died of disease. With a median follow-up of 24 months, the 2-year overall, local control, and disease-free survival rates of all patients were 82.5%, 87.5%, and 59%, respectively. Conclusions: Patients with positive surgical margins were at risk of local recurrence. Postoperative RT should be considered for all surgically treated patients. Level of Evidence: 4.

DOI： 10.1002/lio2.687

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Artificial Organs  

Introduction: We hypothesized that hybrid artificial nerves might overcome the limitations of a nerve conduit by isolating nerve fascicles from autologous nerves. Nerve sacrifice during harvest, a drawback of conventional autologous nerve transplantation, may be reduced by the hot dog method. The hot dog method (based on the morphology of hybrid artificial nerves) adds nerve conduits to autologous nerve fascicles. Methods: Forty-eight rats with a 10-mm sciatic nerve defect were divided into six groups (n = 8 per group) according to the neural reconstruction method: autologous nerve transplantation, the hot dog method, nerve conduit, nerve fascicle transplantation, sham control, and nerve fascicle isolation were classified as Groups I, II, III, IV, V, and VI, respectively. The sciatic nerve function was assessed in these groups, a histological evaluation was performed, and statistical analyses were conducted based on these data. Results: Group III (nerve conduit) and Group IV (nerve fascicle transplantation) showed the lowest functional and axonal regenerative effects, followed by Group II (hot dog method) and Group I (autologous nerve transplantation). Group VI (nerve fascicle isolation) tended to achieve better recovery in motor function and axonal regeneration than Group I (autologous nerve transplantation). Conclusions: The hot dog method is simple, safe, and easy to execute. This method can serve as a new neural reconstruction method that uses artificial nerves.

DOI： 10.1177/03913988211026000

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Craniofacial Surgery  

A total of 47 patients who underwent the craniofacial implantation of unsintered hydroxyapatite particles and a poly-L-lactide device were evaluated for clinical local findings and computed tomography (CT) images after about 6 months. Long-term follow-up of 3 patients was done from 5 to 11 years. The patients underwent CT imaging pre- and postoperatively, while local clinical examination was done upon follow-up. For the 3 patients who were followed up for more than 5 years, implant changes were evaluated by using CT. Computed tomography revealed 3 patients of dislocation, 2 patients of insufficient bone union, and 3 patients of implant breakage. All patients healed well with no complications requiring a secondary operation. The CT findings of the long-term cases revealed the following: a plate and screw were still present 5 years postsurgery (patient 1), mesh implants were completely resorbed after 9 years and 6 months (patient 2), and plates were almost resorbed after 11 years but some of their shapes remained (patient 3). The unsintered hydroxyapatite/poly-L-lactide device is useful in the maxillofacial region in terms of strength and radiographic contrast. However, since the absorption rate is slow, it is necessary to keep in mind its long-term radiographic detectability and the possibility of late-onset granuloma.

DOI： 10.1097/SCS.0000000000007491

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Reconstructive Microsurgery  

Background Intraoperative vasospasm during reconstructive microvascular surgery is often unpredictable and may lead to devastating flap loss. Therefore, various vasodilators are used in reconstructive microsurgery to prevent and relieve vasospasm. Lidocaine is a vasodilator commonly used in microvascular surgery. Although many reports have described its in vitro and in vivo concentration-dependent vasodilatory effects, limited studies have examined the pharmacological effects of lidocaine on blood vessels in terms of persistence and titer. Methods In this study, the vasodilatory effect of lidocaine was examined by using the wire myograph system. Abdominal aortas were harvested from female rats, sliced into rings of 1-mm thickness, and mounted in the wire myograph system. Next, 10, 5, 2, and 1% lidocaine solutions were applied to the artery, and the change in vasodilation force, persistence of the force, and time required to reach equilibrium were measured. Results The vasodilatory effect was confirmed in all groups following lidocaine treatment. Although strong vasodilation was observed in the 10% lidocaine group, it was accompanied by irreversible degeneration of the artery. Vasodilation in the 1% lidocaine group was weaker than that in the other groups 500 seconds after lidocaine addition (p < 0.05). Between the 5 and 2% lidocaine groups, 5% lidocaine showed a stronger vasodilatory effect 400 to 600 seconds after lidocaine addition (p < 0.01); however, there was no significant difference in these groups after 700 seconds. Additionally, there was no difference in the time required for the relaxation force to reach equilibrium among the 5, 2, and 1% lidocaine groups. Conclusion Although our study confirmed the dose-dependent vasodilatory effect of lidocaine, 5% lidocaine showed the best vasodilatory effect and continuity with minimal irreversible changes in the arterial tissue.

DOI： 10.1055/s-0040-1722759

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.7759/cureus.13833

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Surgery Case Reports  

Introduction: Limited literature exists regarding the positional relationship between the pedicled-rectus abdominis myocutaneous (p-RAMC) flap and residual pelvic organs post posterior pelvic exenteration (PPE). Presentation of case: Four patients underwent PPE and reconstruction with a p-RAMC flap. After harvesting the p-RAMC flap with the deep inferior epigastric artery and veins as the vascular pedicle, the intra-pelvic shortest pathway of the flap was created. We dissected the subcutaneous tissues of the flap donor site toward the perineal defect along the inner wall of the pelvis. The pubic origin of the rectus abdominis muscle was preserved. A three-dimensional model was constructed using an image processing software. The vascular pedicle ran almost linearly along the inner wall of the pelvis. The muscle belly was placed on the pelvic floor through the posterior wall of the urinary bladder which filled the dead space of the resected area. All flaps survived without significant complications. Discussion: Assigning the cranial side of the flap to the perineum and caudal side to the pelvic floor could reduce postoperative intrapelvic complications. By preserving the pubic origin of the rectus abdominis muscle, a shock absorber of the pedicle of the flap was created, preventing over-traction of the flap while passing through the intrapelvic pathway. Conclusion: A p-RAMC flap via intra-pelvic shortest pathway is an ideal reconstructive method for large skin defect in perineal area after PPE.

DOI： 10.1016/j.ijscr.2021.02.015

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Advanced mandibular osteoradionecrosis (ORN) sometimes requires extended resection (e.g., hemimandibulectomy). Bacterial infection contributes to ORN pathogenesis. To control infection and determine the extent of debridement required, an understanding of bacterial spread within sites of mandibular ORN is important. The current study used a histopathological approach to assess bacterial colonization in the mandibular condyle and elucidate possible paths of bacterial spread towards the mandibular condyle. Four hemimandibulectomy specimens were selected. Areas of bone destruction were macroscopically assessed and confirmed using hematoxylin and eosin staining. Bacterial presence within mandibular condyle was confirmed with Gram staining. Bone exposure was observed in the molar area in all specimens. Macroscopic bone destruction was apparent especially near the medial side of the cortical wall. Gram staining revealed bacterial colonization of the mandibular condyle in three of the four specimens. In conclusion, bacteria tended to spread posteriorly and through the medial side of the mandibular cortical wall. In patients with advanced ORN, the potential for bacterial colonization of the mandibular condyle should be considered during treatment.

DOI： 10.1155/2021/9998397

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記述言語：日本語   出版者・発行元：Journal of Cranio-Maxillofacial Surgery  

Purpose: This study aimed to examine the usefulness of treating orbital blowout fracture using a customized rigid carrier. Material and methods: Patients who underwent surgery for orbital blowout fractures in our department from April 2016 to March 2019 were recruited in the study. We molded a rigid thermoplastic material into the same shape as the reconstruction material according to the 3D model and transplanted it into the orbital space along with the reconstruction material. We assessed Hertel exophthalmometry, awareness of diplopia, and the Hess area ratio (HAR%). Results: We performed this procedure in 15 patients with blowout fractures. Reconstruction materials used were iliac bone, absorbable plates, and titanium mesh in 12, 2, and 1 patient, respectively. None of the patients showed a difference of more than 2 mm on Hertel exophthalmometry. Only one patient had diplopia after surgery. The average preoperative and postoperative HAR% were 83.1 and 90.6, respectively. HAR% was more than 85% in 6 of 7 postoperative cases. Conclusions: This method can be applied for surgery using various reconstructive materials and can be a useful method, especially in patients with a wide range of orbital bone defects.

DOI： 10.1016/j.jcms.2020.09.002

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記述言語：日本語   出版者・発行元：Journal of Craniofacial Surgery  

Correct anatomical reconstruction of the orbital wall for function and cosmesis is important; however, this is difficult because of the structure’s complexity. The authors aimed to analyze and classify orbital morphology from computed tomography (CT) images and examine the relationship between orbital morphology and eyelid morphology in the Japanese population. CT images of 60 men (right side, 29; left side, 31) and 44 women (each side, 22) were included. The lengths of the orbital medial wall and floor in the coronal plane at the anterior, middle, and posterior planes of the orbit; angle between them; simotic index; and the thickness of upper eyelid were measured. Additionally, the presence or absence of double eyelids was evaluated. Non-paired Student’s t test and Pearson correlation coefficient test were used for analysis. Orbital morphology was symmetrical on both sides, and men had a larger orbit than women. Orbital morphology was classified into 2 groups according to the posterior angle, and there was a difference between the groups in the simotic index. The difference between groups may represent a genetic difference between the Jomon and Yayoi people and not only provide a new classification for the orbit of the population but also be useful in orbital reconstruction.

DOI： 10.1097/SCS.0000000000006634

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記述言語：日本語   出版者・発行元：Operative Neurosurgery  

DOI： 10.1093/ons/opaa124

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記述言語：日本語   出版者・発行元：Pediatric Dermatology  

Infantile hemangioma (IH) is a benign vascular tumor that gradually involutes over several years. Rapidly involuting congenital hemangioma (RICH) is the relatively rare congenital vascular tumor that is fully grown at birth and does not undergo postnatal growth and involutes during the first year. However, after involution of both IH and RICH, some have severe sequelae, such as redundant skin or conspicuous scarring, requiring additional treatment. We present the case of a 6-year-old girl with a concave deformity due to subcutaneous atrophy, skin darkening, and altered skin texture of her left zygomatic region following involution of a hemangioma. We successfully treated this patient by transferring a dermal fat graft. This technique can be beneficial for atrophic sequelae after regression of a hemangioma and is easy to perform and cosmetically effective.

DOI： 10.1111/pde.14207

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記述言語：日本語   出版者・発行元：Genes to Cells  

The human skin has previously been described to be affected by light; however, the underlying mechanism remains unknown. OPN4 (melanopsin) expression was first identified in the skin of amphibians; however, whether it is also expressed and functioned in the human skin has not yet been identified. Here, we show that OPN4 was expressed in the human skin tissue and cultures of isolated keratinocytes, melanocytes and fibroblasts. Additionally, Ca2+ influx in vitro and ex vivo and phosphorylation of extracellular signal-regulated kinases 1/2 in human fibroblasts were observed by stimulation of blue light irradiation. Notably, our findings showed that this Ca2+ influx and phosphorylation of extracellular signal-regulated kinases 1/2 are promoted in an intensity-dependent manner, indicating that the light signal is converted to an intracellular signal via OPN4 in the human skin. Overall, in this study we showed that the human skin functions as a photoreceptor by demonstrating that in human skin, the photoreceptive protein was expressed, and photoreception was conducted via photoreceptive protein.

DOI： 10.1111/gtc.12751

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記述言語：日本語   出版者・発行元：Journal of Plastic, Reconstructive and Aesthetic Surgery  

Background and objective: Forearm free flaps are used after hemiglossectomy. However, no investigation has been performed on whether oral functions are better preserved when sizes of the resection and reconstruction flap are exact matches, or whether the size of the resection should be changed. We aimed to retrospectively examine whether size differences between the resection and reconstruction flap affect speech and swallowing functions postoperatively, and to determine whether there are more favorable flap size ratios. Methods: This is a retrospective cohort study of patients undergoing hemiglossectomy using a forearm free flap between 2006 and 2016 at Kobe University Hospital, Japan. The effect of size difference between the resection and reconstruction flap on maintained oral function was assessed. Speech and swallowing functions were assessed, and their correlation with the ratio of the flap size to that of the resected area was determined. With these data, distribution maps of the relationship between the functional level and reconstructed dimension ratio were prepared. The more suitable reconstructed dimension ratio was examined and evaluated. The Fisher exact test, Kruskal–Wallis test, and Scheffe test were used in statistical analyses. Results: Eighty-eight patients underwent hemiglossectomy using a forearm free flap during a 10-year period. Of these cases, 66 patients were included in this study, while 22 were excluded. The ratio of the area of the reconstruction flap to that of the resection site was 0.59–2.79 (median: 1.61). Sixty patients had flaps greater than the resection area, whereas 6 had smaller flaps. Significant differences were found in speech intelligibility and swallowing function when the reconstructed dimension ratio was categorized as follows: ≤1.3, 1.3–1.8, and ≥1.8. Conclusion: Our findings suggest that postoperative deterioration of oral functions after hemiglossectomy could be reduced if reconstruction is performed using a forearm free flap with a surface area 1.3 to 1.8 times greater than that of the resection area.

DOI： 10.1016/j.bjps.2019.03.015

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記述言語：日本語   出版者・発行元：Kobe Journal of Medical Sciences  

Background: Prolonged drain placement occasionally causes complications such as infection in patients who have undergone implant-based breast reconstruction; therefore, the drainage period must be shortened to avoid complications. Purpose: To identify the factors that prevent prolonged drain placement in patients who have undergone immediate breast reconstruction with tissue expanders. Methods: This was a retrospective medical chart review of all patients who underwent immediate breast reconstruction with tissue expanders at a single center from April 2013 to March 2016. Closed-suction drains were placed in and on the implant pocket. An extra drain was positioned in the axilla in patients undergoing axillary lymph node dissection. The drains were removed at a drainage volume of ≤50 ml per 24 hours. Prolonged drain placement was defined as a period greater than the 75th percentile among all patients. Nine potential risk factors associated with prolonged drain placement were analyzed with multivariate logistic regression analysis. Results: In total, 89 tissue expanders in 89 patients were placed in this study. Prolonged drain placement, determined as ≥9 days (range, 5–14 days), was significantly associated with body mass index ≥25 kg/m2, tissue expander size ≥500 ml, and intraoperative bleeding ≥100 ml, in the multivariate analysis. Axillary lymph node dissection with extra-axillary drainage did not prolong the drainage period. Conclusions: Our findings suggested that placing an extra-axillary closed-suction drain following axillary dissection, and reducing intraoperative bleeding and surgical trauma, could prevent prolonged drain placement in immediate breast reconstruction with tissue expanders.

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記述言語：英語   出版者・発行元：Case Reports in Plastic Surgery and Hand Surgery  

A reverse vascular pedicle digital island flap is a useful treatment option for reconstruction in fingertip amputation. We describe a surgical procedure to preserve the dorsal branch of the digital nerve in the middle phalanx during elevation of this flap with favourable outcomes.

DOI： 10.1080/23320885.2019.1632202

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記述言語：英語   出版者・発行元：Case Reports in Plastic Surgery and Hand Surgery  

Teratomas and lymphatic malformations are included in the differential diagnosis of congenital neck masses. They can exhibit similar clinical findings. The authors present a case of mature teratoma that had been managed as a lymphatic malformation for years. Clinicians should be careful not to dismiss clues for the correct diagnosis.

DOI： 10.1080/23320885.2019.1619458

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記述言語：日本語   出版者・発行元：Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology  

Oroantral fistulas (OAF), which develop as a result of maxillary sinus infection caused by oroantral communication, are sometimes intractable. We present a case of closure with a facial artery musculomucosal flap (FAMM flap) for intractable OAF. A 73-year-old man presenting with an OAF and rhinorrhea was referred to our department. Twenty-eight years earlier, he had undergone bilateral radical surgery for maxillary sinusitis, and six years earlier, he underwent extraction of his right maxillary first and second molars. Six months after the dental extractions, he developed maxillary sinusitis secondary to oroantral communication. Four years after the dental extractions, he underwent endoscopic sinus surgery with closure of the OAF with a rotational pedicled palatal flap, but the OAF recurred. To treat the OAF recurrence, we used a FAMM flap. His postoperative course was good, with no OAF recurrence 6 years after surgery. FAMM flaps are useful to close intractable OAFs.

DOI： 10.1016/j.ajoms.2018.05.001

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記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

For sclerotherapy in venous malformations, three agents, i.e., ethanol, ethanolamine oleate, and polidocanol have been used in Japan. Among these, superiority with regard to outcome and complications has rarely been discussed. Between June 2000 and July 2015, we had 187 patients with venous malformations who were treated by percutaneous sclerotherapy with surfactant sclerosants; we evaluated the efficacy and safety of the therapy retrospectively. Patients were divided into three subgroups depending on the surfactant sclerosants used for treatment: liquid ethanolamine oleate (1-EO group; n=68, 128 sessions), foamy ethanolamine oleate (f-EO group; n=56, 101 sessions), and foamy polidocanol (f-Po group; n=63, 81 sessions). High success rate with excellent and good outcomes were as follows: 71% in the 1-EO group, 65% in the f-EO group, and 78% in the f-Po group. There was no significant difference among the 3 subgroups. Hemoglobinuria occurred in 49 sessions (38%), in 26 sessions (26%), and none, in the 1-EO, f-EO, and f-Po groups, respectively. Thus, less hemoglobinuria was observed with the use of f-Po in comparison with the other two agents. Soft tissue necrosis occurred in 18 sessions (14%), 9 sessions (8%), and 2 sessions (2%) in the 1-EO, f-EO, and f-Po groups, respectively. Therefore, f-Po showed lower incidence of tissue necrosis compared with 1-EO. Since polidocanol demonstrated lower complication rates than ethanolamine oleate, while its efficacy was equivalent to that of the other agents, polidocanol is strongly recommended as a useful surfactant sclerosant for the treatment of venous malformations in Japan.

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記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

Although various grafts using autogenous bone, autogenous cartilage, and alloplastic substitutes have been used for orbital wall reconstruction in facial fracture surgery, none have proven to be the gold-standard graft material. We have used iliac cancellous bone sheets as graft material in cases of orbital fracture. The iliac cancellous bone graft is considered the most appropriate material for orbital wall reconstruction because it is pliable enough to fit the delicate curve of the orbital wall and soft enough to be cut easily with surgical scissors. Here, we describe the details of our surgical technique for orbital floor reconstruction with iliac cancellous bone. A summary of our procedure for orbital floor fracture repair is as follows : 1. to approach the orbital floor, a subciliary incision is usually used ; 2. the fracture and defect site are exposed subperios-Teally, and the orbital content herniating into the maxillary sinus is carefully repositioned ; 3. a milli-meter-Thick bone block is harvested from the ileum; 4. the harvested block is thinned to a 1-2 mm-Thick cancellous bone sheet with a surgical burr ; 5. the sheet is adequately trimmed with surgical scissors; and 6. the sheet is placed onto the orbital floor to cover the bone defect without fixation.

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CiNii Research

記述言語：日本語   出版者・発行元：日本皮膚悪性腫瘍学会  

<p>67歳，男性。初診より約1年前から左母趾爪甲に黒色斑を自覚した。その後，病変が拡大し，爪破壊も生じたため当院皮膚科を受診した。臨床所見で左母趾悪性黒色腫，PET-CTで膝窩ならびに鼠径リンパ節転移を疑われ，当科を紹介受診した。原発巣切除と同時にセンチネルリンパ節生検術，膝窩リンパ節郭清術を施行した。原発巣はtumor thickness 11mmで骨膜に浸潤していた。鼠径リンパ節生検は1/3（浅鼠径リンパ節への転移），膝窩リンパ節郭清は1/2（深膝窩リンパ節への転移）陽性で，後日鼠径リンパ節郭清を施行しリンパ節転移は認められなかった。原発巣が母趾骨膜まで浸潤していたため，骨膜から深部リンパ管を介し深膝窩リンパ節へ転移した可能性が示唆された。原発巣が深部組織に及ぶ場合は，深在リンパ管への流れも考慮することが大切であると思われる。</p>

DOI： 10.5227/skincancer.31.233

CiNii Research

出版者・発行元：株式会社医学書院  

DOI： 10.11477/mf.1411200656

CiNii Research

出版者・発行元：株式会社医学書院  

DOI： 10.11477/mf.1411200665

CiNii Research

記述言語：日本語   出版者・発行元：Regenerative Therapy  

Introduction: Several methods of nerve reconstruction for facial nerve palsy are known. Although the recently introduced method of "cross-linking" of the facial and hypoglossal nerves with a grafted nerve has proved efficacious, the underlying mechanism is unclear. Methods: In this study, we created an animal model with Wistar rats and analyzed the newly reconstructed neural circuit by anterograde and retrograde neural tracer methods. The saphenous nerve was harvested as a graft, and its double end-to-side neurorrhaphy with the facial and hypoglossal nerves with epineural windows was carried out under the microscope. After an appropriate interval, small amounts of fluoro-ruby or fluoro-emerald were injected into the animals and analyzed 5 days later by fluorescent microscopy (Anterograde experiment: fluoro-ruby into the hypoglossal nucleus at 5 weeks; retrograde experiment: fluoro-ruby into the distal facial nerve sheath and fluoro-emerald into the distal hypoglossal nerve sheath, both at two months.). Results: The labeled axons derived from the hypoglossal nucleus were observed passing through the grafted nerve to the facial nerve. On the other hand, retrogradely labeled neurons were observed at both the hypoglossal and facial nuclei with some double-labeled neurons, suggesting that collateral sprouting had occurred. Conclusions: We suggest that the newly constructed neural circuits we observed are conducive to the treatment of facial nerve palsy.

DOI： 10.1016/j.reth.2015.05.003

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記述言語：日本語   出版者・発行元：一般社団法人 日本創傷外科学会  

局所陰圧閉鎖療法 (negative pressure wound therapy : 以下 NPWT) は有用な創傷治療への機器であるが，出血，感染など原因によりその継続が困難となる場合がある。ほかに交換時の疼痛や有毛部におけるエアリークなども治療の継続を妨げる要因となりえる。一方，近年，創傷被覆材の開発が進み，ソフトシリコン粘着剤が多用されるようになってきた。本粘着剤は剥離時の疼痛が少ない，ゲル状であるため微細な凹凸にも密着できる，といった特徴をもつ。われわれはソフトシリコン粘着剤付き創傷被覆材と NPWT とを組み合わせることで患者の疼痛の軽減および有毛部でのエアリークの改善を行えた。コスト面での課題は残るが，ソフトシリコン粘着剤付き創傷被覆材と NPWT との組み合わせは，NPWT の装着適応部位の拡大や交換時の疼痛の改善に寄与すると考えられる。

DOI： 10.11310/jsswc.6.125

CiNii Research

記述言語：日本語   出版者・発行元：日本皮膚悪性腫瘍学会  

DOI： 10.5227/skincancer.30.157

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記述言語：日本語   出版者・発行元：日本マイクロサージャリー学会  

The goal for foot reconstruction is to restore the structure and walking function. To achieve this goal, it is important to assess precisely the defects in anatomical structure, residual function, reconstructive procedure, and postoperative therapy, including rehabilitation and fitting of braces or footwear. We experienced twelve free tissue transfers and thirteen pedicle skin flaps for foot reconstruction in our hospital or branch hospitals. In all cases, tailored braces or footwear were used postoperatively under advice from a prosthetist. The free flaps we selected were: one rectus abdominis musculo-cutaneous flap, six latissimus dorsi musculo-cutaneous flaps, three groin flaps, a free scalp flap, and a scapular flap. Two of the patients who underwent free latissimus dorsi musculo-cutaneous transfer had a failed procedure due to vascular thrombus. The pedicled flaps we used were: six distally based sural flaps, five medial plantar flaps, and two lateral calcaneal flaps. Partial flap necrosis was encountered in two of six distally based sural flaps. Ulceration developed in one flap due to bulkiness. As restoring foot contour is ideal for foot reconstruction, we conclude that using thin flaps or thinning of flaps avoids bulkiness. Subsequent footwear fitting is also very important.

DOI： 10.11270/jjsrm.27.79

CiNii Research

記述言語：日本語   出版者・発行元：日本マイクロサージャリー学会  

The development of microvascular surgery has been contributed the patients' quality of life after the expanded resection of malignant tumor or large tissue defect caused by trauma. On the other hand, vascular complication, such as thrombosis, relates to the flap necrosis and strict monitoring of flap condition is necessitated. We basically monitor the flap every 4 hours for 5 days by inspection or palpation. In addition, we have been introduced blood glucose measurement, regional oxygen saturation index ( rSO<SUB>2</SUB> ), pulse oximeter ( SpO<SUB>2</SUB> ) and indocyanine green fluorescent ( ICG ) imaging for flap auxiliary monitoring. Because each of those methods has advantage and disadvantage, understanding of characteristics of each methods may helps us the earlier detection of vascular trouble, which directly relate to the flap salvage rate.

DOI： 10.11270/jjsrm.27.72

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記述言語：日本語   出版者・発行元：一般社団法人 日本口腔腫瘍学会  

DOI： 10.5843/jsot.26.53

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記述言語：日本語   出版者・発行元：一般社団法人 日本創傷外科学会  

重症下肢虚血 ( critical limb ischemia : CLI ) 症例で，始めは下肢小切断術を計画していても血行再建術後の感染増悪により，結果的に下肢大切断術に至る場合がある。2005 年～ 2009 年までの 5 年間に経験したCLI症例 13 例のうち 3 例が大切断術となった。大切断術に至った症例と小切断術で治癒した症例について，患者因子を基に比較検討を行った。年齢，糖尿病の罹患の有無，血糖コントロールの方法，腎機能，対側の下肢切断歴の有無，血行再建前後と局所手術後早期のCRP値，局所手術前の栄養状態について検討を行った。患者因子として①糖尿病性腎症 (末期)，②反対側の下肢切断歴，③低栄養が大切断のrisk factorとなっていた。また，血行再建術後と比較し，局所手術後早期のCRP値が高い症例は大切断術となる可能性を示唆し，周術期のCRP値が大切断術を回避するための指標の 1 つとなる可能性を示唆した。

DOI： 10.11310/jsswc.5.189

CiNii Research

記述言語：日本語   出版者・発行元：社団法人 日本口腔外科学会  

Necrotizing fasciitis is treated by incisional drainage or immediate debridement. Generally, an infected wound should not be sutured or closured, but should be allowed to secondarily heal as an open wound. Treatment of necrotizing fasciitis involving the neck or submandibular region requires careful attention to major blood vessels or nerves. We therefore could not perform debridement radically. The wound should be continuously irrigated or applied ointment, but the presence of a fistula sometimes leads to prolonged wound healing.<BR>We describe our experience with an uncontrollable fistula attributed to debridement of submandibular necrotizing fasciitis, although irrigation had been continued for 6 weeks. After performing Negative Pressure Wound Therapy, with a V.A.C.^® ATS system good granulation tissue proliferated in 3 days, and the fistula disappeared. The wound completely healed in 1 week. Furthermore, the clinical course has been good, with no recurrence of a fistula after 3 months. We report a case of early healing of an uncontrollable fistula treated by a V.A.C.^® ATS system.

DOI： 10.5794/jjoms.60.71

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記述言語：日本語   出版者・発行元：一般社団法人 日本口腔腫瘍学会  

口腔腫瘍切除後の下顎区域欠損に対する新しい分類法「CAT分類」と再建理論「CATコンセプト」について報告する。それぞれの概要は以下の通りである：<br>CAT分類—下顎骨における輪郭点である下顎頭（Condylar Head），下顎角（Mandibular Angle），オトガイ結節（Mental Tubercle）の3つ（両側で6つ）を基準点とし，それぞれをC点，A点，T点と定義する。これらの点の組合せで下顎区域欠損を分類する方法である。基準点を含む欠損の場合にそれぞれ「C」「A」「T」と分類し，複数の基準点を含む欠損の場合は「CA」「AT」「CAT」などとする。基準点のところで切除された場合は欠損に含まない。基準点を含まない下顎枝のみの欠損は「neck」，下顎体部のみの欠損は「body」とする。CATコンセプト—標準的な下顎再建手術を行うには，CAT分類の基準点であるC，A，Tを再現することが必要かつ十分な条件であるとする理論である。<br>これまでの研究の結果，これらは下顎再建を標準化する際の有用な基本理論であることが示されている。

DOI： 10.5843/jsot.26.57

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記述言語：日本語   出版者・発行元：一般社団法人 日本創傷外科学会  

足趾潰瘍や腫瘍が MTP 関節レベルまで及ぶ例では, 切除断端の被覆のために中足骨近位での切断を要する場合や, 肉芽の増生を待ったのちに二期的に植皮を要する場合がある。しかし足部切断例においては切断レベルが術後の ADL を左右し, また術後の長期安静期間は廃用性障害につながるため, 早期の創治癒が求められる。そこで, われわれは足趾切断時に切除が足趾の半側までに留まる場合では趾動脈を血管茎とする fillet toe flap を作成し, 可及的に骨を温存し, 一期的に創を閉鎖している。今回, 強皮症および PAD による虚血性潰瘍と悪性腫瘍切除後の欠損に対して本法を施行し良好な結果を得た。足趾の片側に潰瘍が留まるのは限られたケースではあるが, fillet flap として残存組織を利用するにあたり, なんら犠牲を伴わないばかりか, 知覚皮弁としても利用できるうえ, 切断レベルを最小にし, すみやかな創治癒を期待できることから, 一考に値するとわれわれは考える。

DOI： 10.11310/jsswc.3.123

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記述言語：日本語   出版者・発行元：一般社団法人 日本創傷外科学会  

眼窩下壁骨折手術の際に用いる眼窩壁再建材料として，われわれは腸骨髄質をシート状に成形したものを好んで用いており，これまでに自験例を対象とした検討で良好な治療成績を示してきた。本稿では，その手技を示し，眼窩壁再建材料としての有用性について報告する。<br>　手術手技：1）睫毛下切開から眼窩下壁の骨欠損を明示する，2）腸骨内板から髄質を数mm含む厚さで骨を切り出す，3）皮質をバーで削り，厚さ1～2mmの髄質骨でできたプレート状の移植材料を作製する，4）欠損よりもやや大きく成形したものを眼窩壁に移植するが，特別な固定は行わない。<br>　腸骨髄質は剪刀で切れるほど軟らかく，適度にしなやかである。さらに，眼窩下壁全域に移植しても耐えうる強度を有している。CTによる観察では，術後数ヵ月で骨化することが示唆されている。きわめて扱いやすいうえに，耐久性のある移植材料であり，眼窩壁の再建材料として有用である。

DOI： 10.11310/jsswc.2.97

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記述言語：英語   出版者・発行元：日本マイクロサージャリー学会  

Weakness, hypertonicity, loss of isolated control and/or synkinetic movement of the facial mimetic muscle are common sequelae after facial palsy, unlike disruption of nerve continuity as in Bell's palsy or Hunt's syndrome. Here we describe a surgical procedure and postsurgical rehabilitation for the treatment of such sequelae.<BR>The surgical procedure comprises facial and hypoglossal nerve cross-linking that connects the nerves by an interpositional nerve graft with end-to-side anastomosis. For postsurgical physical rehabilitation, patients are instructed in the following techniques for facial neuromuscular retraining: 1) to practice isolated facial motion in front of a mirror (mirror-biofeedback technique); 2) to avoid gross voluntary movement both during practice and in daily life; and 3) to frequently massage and stretch the affected facial muscle.<BR>Between December 2005 and May 2008, twenty patients with sequelae after facial palsy were treated by our rehabilitation technique. Sixteen patients showed improvement in abnormal facial movement, while four did not. None of the patients developed facial synkinesis associated with tongue motion. Our surgical procedure and postsurgical rehabilitation exercises are alternative techniques for the sequelae of facial palsy.

DOI： 10.11270/jjsrm.24.267

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記述言語：日本語   出版者・発行元：Toukeibu Gan  

Background: We have previously proposed the CAT classification system, a simple and clear-cut system for classifying segmental mandibular defects after oncological surgery: “C” refers to the loss of the condylar head of the mandible, “A” the mandibular angle and “T” the mental tubercle. Here, we report a statistical and mathematical taxonomical study on the validity and utility of the classification system. Methods: Data were collected from 17 medical institutions in Japan on 259 patients who had undergone surgical ablation and simultaneous microsurgical oromandibular reconstruction (osteocutaneous free flap or soft tissue free flap with reconstruction-plate) attributed to head and neck cancer. The mandibular defects were classified according to the CAT system and the two commonly used systems HCL and Urken, and the validity and utility of the CAT system were tested as follows: 1) the tendency among the numbers of the three reference points of the CAT system (C, A and T) and the esthetic outcome of each patient were analyzed by Jonckheere's trend test, 2) each of the classified patterns of the three systems was analyzed by cluster analysis based on the esthetic results using Ward's method. Results: 1) There was a statistically significant trend among the numbers of the three reference points in the CAT system and the esthetic outcome, 2) each of the grouped clusters in the CAT system was clinically explicable and demonstrated a significant difference in the esthetic outcome; the two other systems did not yield such information. Conclusion: The CAT classification system is valid and useful for oncological segmental mandibular defects. © 2010, Japan Society for Head and Neck Cancer. All rights reserved.

DOI： 10.5981/jjhnc.36.309

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記述言語：日本語   出版者・発行元：一般社団法人 日本創傷外科学会  

眼瞼皮膚や眼窩骨に欠損がない外傷後無眼球症の二次的義眼床変形に対するfree flapの適応について検討する。2008年までの10年間に経験した症例を対象とした。外傷後無眼球症の二次的義眼床変形に対する手術症例のうち，眼瞼皮膚や眼窩骨に欠損がない症例について遡及的検索を行い，free flap移植術を適用した症例の治療経過を詳細に調査した。全7例のうち，3例でfree flap移植術が施行されていた。Free flapを移植したのは，受傷後長期間経過してから重度の義眼嚢拘縮をきたしたものが2例，上眼瞼皮下の著明な瘢痕拘縮と陥凹変形をきたしたものが1例であった。眼瞼皮膚や眼窩骨に欠損がない外傷後無眼球症においても，free flapを必要とする症例が一定数存在する。重度かつ進行性の義眼嚢拘縮，眼瞼の著明な瘢痕拘縮を伴う高度な陥凹変形はfree flapの適応基準となることが示唆される。

DOI： 10.11310/jsswc.1.119

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記述言語：日本語   出版者・発行元：社団法人 日本口腔外科学会  

Low-grade myofibroblastic sarcoma is an uncommon neoplasm of atypical myofibroblasts with fibromatosis-like features. The lesion has only been characterized in the last two decades, and the concept of neoplastic myofibroblasts remains controversial. We encountered a patient with low-grade myofibroblastic sarcoma of the maxilla.<br>A 70-year-old woman was referred to our hospital because of swelling of the anterior maxilla. She had undergone repeated surgical procedures of the lesion at other hospitals. The tumor invaded the hard palate, nasal cavity, bilateral maxillary sinus, and cheek skin. The biopsy specimen showed a low-grade myofibroblastic sarcoma, and she underwent wide resection of the lesion and reconstructive surgery using a free forearm flap. Histologic examination revealed diffuse, fascicular proliferation of spindle cells with focal cellular atypia. The tumor cells showed positive reactions for α-SMA and vimentin, which indicated differentiation to myofibroblasts, and the lesion was diagnosed as a low-grade myofibroblastic sarcoma. The patient is free from tumor 13 months after surgery.

DOI： 10.5794/jjoms.55.184

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記述言語：日本語   出版者・発行元：Toukeibu Gan  

Organs with important functions for daily life are concentrated in the head and neck area, and maintaining post-treatment Quality-of-Life (QOL) is also important when treating cancers of the head and neck, in addition to improving survival rate. Free flap reconstruction techniques are expected to contribute to maintaining post-treatment QOL, but these techniques have not been adequately evaluated in Japan. We performed a cross-sectional analysis of QOL, using the Japanese version of the UWQOL (version 4) from the University of Washington in the United States, with 202 patients from 10 institutions who had undergone reconstructive surgery for tongue cancer. In addition to the survey form, we collected clinical information (age, sex, time since surgery, flap donor site, whether radiotherapy was administered, and other factors), and analyzed whether differences in postoperative QOL were seen depending on each of these factors and the hospital at which the surgery was performed. Although a relationship was found between QOL following reconstructive surgery for tongue cancer and the extent of resection, age and whether radiotherapy was administered, fairly good QOL was maintained overall. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.

DOI： 10.5981/jjhnc.35.374

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記述言語：日本語   出版者・発行元：日本頭頸部癌学会  

がん切除後の下顎骨区域欠損に対する新しい分類法を考案したので報告する。この分類法は，下顎頭（condylar head），下顎角（mandibular angle），オトガイ結節（mental tubercle）の3点を基準点とするため，各点の頭文字をとって「CAT分類」と呼称する。CAT分類では，欠損が各点（C，A，T）を含むかどうかを基準として分類を記述する。例えば，下顎角部を含む区域欠損なら「A」，下顎頭から下顎体部までの欠損なら基準点CとAを含むため「CA」と記述し，片側の下顎枝からオトガイ部を経て対側の下顎体部までの欠損なら，A，T，Tを含むため「ATT」となる。基準点を含まない下顎枝のみの欠損なら「neck」，下顎体部のみの欠損なら「body」とする。分類パターンは全部で14あり，臨床上経験するすべての下顎骨区域欠損を分類することが可能である。自験例を対象とした検討ではCAT分類は整容的手術結果を反映することが示唆されたが，機能的結果との関連も含めた今後の検討を要する。CAT分類は，現在頻用されている他の分類法と比較して，単純かつ明快であり術後結果と一定の相関関係にある可能性が高いことから，がん切除後下顎骨区域欠損の有用な分類法となることが期待される。

DOI： 10.5981/jjhnc.34.412

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記述言語：日本語   出版者・発行元：特定非営利活動法人 日本レーザー医学会  

真皮メラノサイトーシスに対しては，selective photothermolysisの理論に基づき開発されたQスイッチレーザー照射が有効な治療法である．しかし，いったん合併症を起こしてしまうと対処に苦慮することが少なくない． <BR>今回，平成12年7月より平成18年6月までに神戸大学医学部附属病院形成外科にて，レーザーを照射した異所性蒙古斑42例53部位を対象に，どのような因子が影響して色素脱失を生じているかについて調べ統計学的な解析を加えた．年齢・性別・部位・レーザーの種類・最大照射エネルギー・照射回数と色素脱失との関連について，ロジスティック回帰による多変量解析を行った．色素脱失は24部位（45.3％）に認められた．体幹は四肢と比べて色素脱失を起こしやすい（オッズ比16.257［95%信頼区間2.367－111.660］，P=0.005）という結果が得られた．年齢・性別・レーザーの種類・照射エネルギー・照射回数は有意な因子とならなかった．今回の検討で得られた結果は極めて興味深いものであり，多方面から検証していく必要がある．

DOI： 10.2530/jslsm.29.26

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記述言語：英語   出版者・発行元：Journal of Cranio-Maxillofacial Surgery  

Purpose: This paper presents surgical techniques for reconstruction of the cheek, oral commissure and vermillion in the repair of full-thickness cheek defects after resection of buccal-mucosal squamous cell carcinoma. Patients and Methods: Four reconstructions in one-stage surgery with either a free radial forearm flap or a rectus abdominis musculocutaneous flap for cheek and oral commissure were carried out. There were combined with a new approach for vermillion advancement flaps. Most challenging was the need not only for morphological reconstruction of the orifice, but also for physiological reestablishment of sphincteric and sensory functions in the vermillion. Results: Morphological and physiological reconstruction of the lip with sphincteric and sensory functions was attained. Conclusion: This valuable reconstruction technique was demonstrated in large, full thickness defects involving the cheek, oral commissure and vermilion. © 2001 European Association for Cranio-Maxillofacial Surgery.

DOI： 10.1054/jcms.2001.0249

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担当区分：最終著者   記述言語：日本語  

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

担当区分：最終著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

担当区分：筆頭著者   記述言語：日本語  

担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：特定非営利活動法人 日本レーザー医学会  

<p>毛細血管奇形（単純性血管腫）に対する色素レーザー治療が普及し約30年が経過した．現在，本邦ではパルス幅可変式ロングパルス色素レーザーによる治療が第一選択であり，近年では紫斑形成が少ない機器も販売されている．小児では治療早期の照射が推奨される傾向があるが，長期には依然再発の問題がある．色素レーザーの治療効果を高める薬剤や治療法の開発が待たれるところである．</p>

DOI： 10.2530/jslsm.jslsm-42_0004

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PubMed

記述言語：日本語   出版者・発行元：Auris Nasus Larynx  

Objective: Free flap reconstruction in elderly patients is one of the most challenging surgeries in the treatment of head and neck cancers. The aim of this study was to examine the oncological and functional outcomes of free flap reconstruction for elderly patients with head and neck cancer. Methods: We retrospectively reviewed elderly patients who underwent free flap reconstruction for the treatment of head and neck cancers. All patients were 80 years or older. Clinicopathologic features, surgical procedures, oncological and functional outcomes were obtained from medical records. Results: Free flap reconstructions were performed in 13 patients (3 female, 10 male). The mean age was 82.6 ± 3.4 years (range: 80–91). The mean follow-up period was 23.3 months (range 4–41 months). The mean disease-free survival was 49 ± 6 months (range 4–60 months). All patients had been alive more than one year after surgery. Reconstruction was performed using free jejunum in 10 patients and radial forearm flap in 3 patients. Graft necrosis occurred in 2 patients. Other two patients experienced major postoperative medical complications. Conclusion: Free flap reconstruction in well-selected older adults is safe and effective. Advanced age should not preclude consideration of free flap reconstruction in those patients.

DOI： 10.1016/j.anl.2019.04.005

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Auris Nasus Larynx  

Cardiac metastasis from head and neck cancers are very rare. Metastases to heart are mostly diagnosed at autopsy, and seldom found while patients are alive. Patients with cardiac metastasis do not present with specific symptoms in the early stages, and diagnosis is often delayed until the disease has advanced significantly. Here, we report a 66-year-old lady who was diagnosed with cardiac metastasis 10 months after surgical resection of oral cancer. She died one month following the discovery of cardiac metastasis. Cardiac metastasis should be considered when unexplained and progressive decline of general health is observed, even in the absence of abnormalities on the electrocardiogram. Early diagnosis may be made by analyzing the chronological changes in the cardiac accumulation of fluorodeoxyglucose during positron emission tomography–computed tomography scan.

DOI： 10.1016/j.anl.2018.10.018

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記述言語：日本語   出版者・発行元：Dentistry Journal  

Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar contracture. A vestibuloplasty technique with application of a polyglycolic acid (PGA) sheet is described. The implants were inserted into a viable fibula flap with severe scar contracture of the overlying epithelium resulting from vascular instability in skin paddle. Only the fibula periosteum was sutured after implant insertion; exposed surfaces were covered with a combination of PGA sheet and fibrin sealant. The area with PGA sheet coverage gradually healed with moderate contracture. The epithelium around the almost implants became immobilized. The implant-supported removable partial denture with custom titanium bar was acceptable. Dental rehabilitation is possible for reconstructed mandibles with severe scar contracture. Application of a PGA sheet may be useful for vestibuloplasty in patients with reconstructed mandibles.

DOI： 10.3390/dj7030065

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Head and Neck  

Objectives: To evaluate the impact of retropharyngeal lymph node (RPLN) dissection in the surgical treatment of hypopharyngeal cancer. Methods: Between 2007 and 2016, 98 previously untreated patients with pathological diagnosed hypopharyngeal squamous cell carcinoma underwent total pharyngolaryngectomy and bilateral neck dissection at Kobe University Hospital. Bilateral dissection of RPLN was simultaneously performed in all patients. Pharynx was reconstructed with free jejunal transfer in 94 patients and primarily closed in 4 patients. Postoperative chemoradiotherapy was performed in patients with high risk factors including metastasis to RPLN, multiple lymph node metastasis, extranodal invasion, and/or positive/close surgical margins. Results: The median follow-up period was 25 months ranging from 1 to 105 months. RPLN adenopathy was preoperatively identified in 9 patients in FDG-positron emission tomography. All of them had pathologically diagnosed RPLN metastases, which had been controlled in all patients during the observation periods. Among the other 89 patients, 7 patients had RPLN metastasis. The 2-year overall survival rates of the patients with and without RPLN metastasis were 65.7% and 69.8% (P =.61), respectively. Conclusions: In the present study, patients with RPLN metastasis showed equally favorable oncological outcome compared with patients without RPLN metastasis. At least, ipsilateral RPLN dissection should be considered in the surgical treatment of advanced hypopharyngeal cancer and multiple neck lymph node metastasis regardless of primary subsite.

DOI： 10.1002/hed.25608

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出版者・発行元：Journal of Reconstructive Microsurgery  

DOI： 10.1055/s-0038-1672134

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Plastic and Reconstructive Surgery - Global Open  

Congenital entropion is an ocular condition involving malpositioning of the eyelid, which can result in ocular pain, conjunctival epiphora, or photophobia. Noninvasive treatment is effective in some cases; however, surgical treatment is indicated when keratitis and ocular irritating symptoms occur. There is no consensus regarding the most appropriate surgical technique. Moreover, some patients complain of changes in their appearance or unwanted incision scars after surgery. In particular, individuals with certain types of Asian heritage exhibit a lower eyelid morphology that differs from that of white individuals, caused by orbital fat locational difference. Subciliary muscle bulges cause swelling in the lower eyelid called Namidabuluro and are considered to create a youthful and beautiful appearance in Asians. Accordingly, some Asian individuals tend to be sensitive about changes to the appearance of the lower eyelid. To our knowledge, no report has yet described changes to Namidabukuro during congenital entropion repair in Asians. We describe a novel surgical technique for congenital entropion repair with the creation of cosmetically natural Namidabuluro in an East Asian cohort. The study included 8 lower eyelids of 4 Japanese female patients. Scarring was not noticeable in any of the 4 cases. Eversion of the cilia and the creation of cosmetically natural Namidabuluro were accomplished in all cases. There has been no case of recurrence yet. The novel surgical technique we developed enables not only the treatment of congenital entropion but also the creation of cosmetically acceptable Namidabuluro, resulting in increased patient satisfaction.

DOI： 10.1097/GOX.0000000000002122

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

出版者・発行元：International Journal of Surgery Case Reports  

DOI： 10.1016/j.ijscr.2019.01.018

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記述言語：日本語   出版者・発行元：日本皮膚悪性腫瘍学会  

DOI： 10.5227/skincancer.34.78

CiNii Research

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology  

Objective: Pain is one of the most problematic symptoms in patients with osteoradionecrosis of the jaws. This study investigated the associations between pain severity and morphologic alterations of the mandibular canal and inferior alveolar nerve, in respective computerized tomography images and resected specimens of mandibular osteoradionecrosis. Study Design: We assessed 14 lesions in 13 patients who underwent segmental mandibulectomy for surgical debridement and simultaneous reconstruction with free fibula flap (1 patient exhibited bilateral lesions). The extent of the mandibular canal bone defect on preoperative coronal computerized tomography images and the number of inferior alveolar nerve fascicles in resected specimens were evaluated. Comparisons were made between the slight pain and extreme pain groups. In most of the patients in the extreme pain group, either mandibular canal bone defects were absent or entire circumferential defects were present; inferior alveolar nerve fascicles were either distinguishable or completely absent in the resected specimens. Results: Although there was no statistically significant association between extreme pain and computerized tomography or histopathologic findings, the histopathologically indistinguishable inferior alveolar nerve fascicles was significantly associated with slight pain. Conclusions: The degree of degeneration of mandibular canal and inferior alveolar nerve may be associated with pain severity in patients with mandibular osteoradionecrosis.

DOI： 10.1016/j.oooo.2018.03.017

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Neurological Surgery, Part B: Skull Base  

Objective Nasal and paranasal malignant tumors invading the skull base are rare and poorly studied. We evaluated postoperative complications in patients undergoing salvage surgery for such tumors. Design Retrospective study. Setting Kobe University Hospital. Participants Among 48 patients who underwent surgery for tumors involving the skull base between 1993 and 2015, 21 patients had squamous cell carcinoma, 13 had olfactory neuroblastoma, 5 had adenocarcinoma, 2 had sarcoma, 2 had adenoid cystic carcinoma, and 1 each had malignant melanoma, poorly differentiated carcinoma, undifferentiated carcinoma, myoepithelial carcinoma, and malignant peripheral nerve sheath tumor. Prior to skull base surgery, radiotherapy, chemoradiotherapy (CRT), particle radiotherapy, chemotherapy, or surgery were applied in 3, 15, 4, 5, and 3 patients, respectively. Main Outcome Measures Main outcome measures were postoperative complications in patients who underwent skull base surgery after concomitant CRT and/or particle therapy. Results Major postoperative complications were observed in 14 surgical procedures (29%; 2 patients with cerebral herniation, 3 with cerebrospinal fluid leakages, 3 with meningitis, 1 with hydrocephalus, 6 with epidural abscesses, 2 with local infections, and 2 with partial flap necrosis). Four patients developed ≥2 complications. One patient died of postoperative lung infarction. Three (16.7%) of 18 patients without prior treatment and 9 (50%) of 18 patients who underwent preoperative radiotherapy/CRT had severe postoperative complications. Two (50%) of four patients treated with particle radiotherapy had postoperative complications. Conclusions CRT or particle radiotherapy were significantly associated with a high risk of severe postoperative complications after skull base surgery. Meticulous care should be taken in patients treated with radiotherapy/particle therapy prior to skull base surgery.

DOI： 10.1055/s-0037-1606382

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出版者・発行元：Lymphatic Research and Biology  

DOI： 10.1089/lrb.2016.0063

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

出版者・発行元：Plastic and Reconstructive Surgery - Global Open  

DOI： 10.1097/GOX.0000000000001776

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

DOI： 10.3892/mco.2017.1477

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Cranio-Maxillofacial Surgery  

Objective Few studies evaluate condylar movement following mandibular reconstruction. The main objective of this study was to show that axial four-dimensional computed tomography (4DCT) could visualize bilateral protrusive condylar movement directly. We used axial 4DCT images to assess condylar protrusion in patients who underwent mandibular reconstruction. Methods We enrolled seven healthy volunteers (median age 30 years, range 27–38 years) and seven patients (median age 65 years, range 52–80 years), who underwent mandibulectomy (segmental in five, hemi in one, marginal in one) and free flap reconstruction (using the fibula in six and the radial forearm in one). Six study subjects were instructed to masticate a cookie during the 4DCT scan (the seventh made chewing motions). The distance between the most anterior and posterior positions of the bilateral condyles on 4DCT (axial view) images was then measured and compared between controls and patients using the Mann–Whitney U-test. Results The crosswise difference in the distances of condylar protrusion was significantly greater in patients than in the controls. Conclusion Axial 4DCT images can visualize a bilateral condylar protrusive path. Axial 4DCT images for patients who have undergone mandibulectomy and reconstruction may be useful for evaluation of functional movement of condyles.

DOI： 10.1016/j.jcms.2017.08.025

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記述言語：英語   出版者・発行元：Surgical Infections  

Background: The lack of uniformity of criteria for defining recipient-site infection after oral oncologic surgery with simultaneous reconstruction is problematic despite numerous studies on this issue. This study aimed to investigate the difference in the criteria for defining recipient-site infection after oral oncologic surgery with reconstruction. Methods: A Medline search was performed via PUBMED using the following combinations of key terms that were tagged in the title, abstract, or both: "surgical site infection-head neck," "surgical site infection-oral cancer," "antibiotic prophylaxis-head neck," and "surgical site infection-oral carcinoma." Search results were filtered between 2005 and 2017. Articles in which there was no mention of the criteria for definition of surgical-site infection were excluded. Results: The number of articles that met the inclusion criteria was 24. The lack of uniformity in the criteria for defining recipient-site infection in each article appeared to be attributable mainly to differences in whether an orocutaneous fistula and superficial incisional infection were regarded as recipient-site infection. Conclusion: Reconsideration of the categorization of orocutaneous fistula as infection, regardless of the etiology, and differentiation of superficial and deep incisional infections are necessary for correct assessment of recipient-site infection in oral oncologic surgery.

DOI： 10.1089/sur.2017.101

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記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Oral and Maxillofacial Surgery Cases  

Nasal polyps are inflammatory proliferative tumors arising from the mucosa of the nasal cavity and paranasal sinuses. Although many cases concerning nasal polyps have been reported, those involving external nasal deformities are rare. We report a case of nasal polyposis filling the nasal cavity and paranasal sinuses, leading to external nasal and facial deformities. The condition above is known as Woakes’ syndrome, which is characterized by severe recurrent nasal polyps with deformity of the nasal pyramid, leading to broadening of the nose. We performed nasal osteotomy and facial bone-shaving via the midface degloving approach, which improved the patient's facial appearance.

DOI： 10.1016/j.omsc.2017.05.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PLoS ONE  

Objectives Transient receptor potential cation channel (subfamily V, members 1±4) (TRPV1±4) are expressed in skin and neurons and activated by external stimuli in normal mucosae of all oral cavity sites. The oral cavity is exposed to various stimuli, including temperature, mechanical stimuli, chemical substances, and changes in pH, and, notably, the risk factors for oncogenic transformation in oral squamous epithelium are the same as the external stimuli received by TRPV1±4 receptors. Hence, we examined the relationship between oral squamous cell carcinoma (SCC) and TRPV1±4 expression. Materials and Methods Oral SCC patients (n = 37) who underwent surgical resection were included in this study. We investigated the expression of TRPV1±4 by immunohistochemical staining and quantification of TRPV1±4 mRNA in human oral mucosa. In addition, we compared the TRPV1±4 levels in mucosa from patients with SCC to those in normal oral mucosa. Results The receptors were expressed in oral mucosa at all sites (tongue, buccal mucosa, gingiva, and oral floor) and the expression was stronger in epithelia from patients with SCC than in normal epithelia. Furthermore, alcohol consumption and tobacco use were strongly associated with the occurrence of oral cancer and were found to have a remarkable influence on TRPV1±4 receptor expression in normal oral mucosa. In particular, patients with a history of alcohol consumption demonstrated significantly higher expression levels. Conclusion Various external stimuli may influence the behavior of cancer cells. Overexpression of TRPV1-4 is likely to be a factor in enhanced sensitivity to external stimuli. These findings could contribute to the establishment of novel strategies for cancer therapy or prevention.

DOI： 10.1371/journal.pone.0169723

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers.

PubMed

PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BioMed Research International  

Background. This study aimed to analyze differences in necrotic changes between cortical and cancellous bone in resection margins after segmental mandibulectomy for advanced mandibular osteoradionecrosis. Methods. Anteroposterior bone specimens from eleven patients who underwent segmental mandibulectomy with simultaneous free fibula flap reconstruction for advanced osteoradionecrosis were analyzed histopathologically for the presence of necrotic bone based on the presence of blood vessels within Haversian canals. Results. Ten of eleven (91%) cortices near the inferior border of the mandible at the anterior margins were necrotic. All cancellous bones at the anterior margins were viable. Seven of eleven (64%) cortices near the inferior border of the mandible at the posterior margins were necrotic. Three of eleven (27%) cancellous bones at the posterior margins were necrotic. Conclusion. Necrotic changes are more prevalent in cortices than in cancellous bones in mandibular osteoradionecrosis, probably due to a decrease of periosteal blood supply caused by radiotherapy.

DOI： 10.1155/2017/3125842

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Head and Neck  

Background: Extirpation of tumors arising in the pterygopalatine fossa is challenging because of its anatomic complexity. Methods and Results: A 67-year-old man was referred to our department with a diagnosis of a tumor in his left pterygoid fossa. An incisional biopsy through the canine fossa was diagnosed as myxofibrosarcoma. The upper part of the maxilla was swung laterally to remove the tumor while the hard plate was preserved. The defect was reconstructed using rectus abdominis musculocutaneous free and ipsilateral temporal. The postoperative course was uneventful, without facial palsy or mastication disorders. Conclusion: Our experience with this case suggests that the modified partial maxillary swing approach with preservation of the hard palate and orbital floor in combination with infratemporal and cervical approaches is useful for lesions in the pterygoid process without causing severe complications. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2519–E2522, 2016.

DOI： 10.1002/hed.24558

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記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Oral and Maxillofacial Surgery  

Purpose: This study aimed to compare the size of skin paddles, the postoperative course, and donor site complications between primary closure and skin grafts of the free fibula flap donor site. Methods: Thirty-five consecutive patients were enrolled. Medical records were retrospectively reviewed for risk factors for delayed healing, size of skin paddles, time to resumption of gait with a mobility aid and self-ambulation, early donor site morbidity, and late donor site complaints. Results: The harvested skin paddles were significantly wider in the skin graft group than in the primary closure group (P = 0.02), with no difference in length (P = 0.1). The difference in time to resuming gait with a mobility aid was also significant (P = 0.01), but not the time to self-ambulation (P = 0.9). Two early donor site morbidities (5.7 %) and 12 late donor site complaints (34.3 %) were found. No significant difference in the incidence of early donor site morbidity was observed between two groups. Occurrence of late donor site complaints was not affected by any risk factors. Conclusions: The width of the harvested skin paddle, but not the length, is one of factors involved in donor site closure. Resumption of gait with a mobility aid, but not self-ambulation, may be delayed in skin graft patients.

DOI： 10.1007/s10006-016-0556-3

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記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

Recent advances in microsurgery have enabled surgical anastomosis of small vessels with calibers less than 1 mm. An anastomosis of a small vein and a lymphatic vessel, lymphaticovenous anastomosis (LVA), is an effective surgical treatment for lymphedema. However, because of the particularities of lymphatic vessels such as their small caliber and thin vessel wall, LVA is a difficult treatment to perform. This report presents the usefulness of a surgical suture attached with a straight needle in LVA. Fifty cases where LVAs were carried out with the technique were retrospectively reviewed based on technical viewpoints with medical records including operative reports and videos. The gages of threads used in the procedure were 11-0 and 12-0, and all were made of monofilament nylon. The diameters of the needles were 40um, 50um, 60um and 80um. and the lengths of needles were 3 mm, 4 mm and 5 mm. The calibers of the anastomosed lymphatic vessels were 0.2 mm to 1.0 mm. Both end-to-end and end-to-side anastomoses were performed. All the patients developed no postoperative complications related to the procedure. The review of the cases showed: (1) a back-wall first technique was useful for the anastomosis of vessels with calibers of less than 1 mm; (2) a straight needle was useful for a posterior vessel wall; (3) in particular, direction was easy to control when stabbing a vessel wall with a straight needle; (4) an anterior wall was difficult to stab with a straight needle when the wall was very thick, which was much less frequent in LVA. Some technical refinements are necessary for a reliable procedure in lymphatic microsurgery. The combination of a usual back-wall first technique and a straight needle is an effective alternative in LVA.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Cranio-Maxillofacial Surgery  

Purpose The purpose of this study was to analyze jaw movement during mastication in patients who underwent mandibular reconstruction following segmental mandibulectomy, including mouth opening and mastication time, based on four-dimensional computed tomography (4D CT) images. Material and methods This study included six surgical patients, who underwent segmental mandibulectomy and simultaneous reconstruction with a free fibula osteocutaneous flap, and four controls. 4D CT was performed during mastication of a cookie to evaluate the movement of the jaw during natural function. The maximum mouth opening, mastication time, and movement of the mandibular angle during mastication were evaluated from the 4D CT images. Results 4D CT images enabled visualization of jaw movement during mastication. When compared with the controls, the maximum mouth opening during mastication and excursion of the mandibular angle, especially on the diseased side, tended to decrease in surgical patients; however, this did not occur with mastication time. The numerical differences between the diseased and nondiseased side in surgical patients tended to be higher than the crosswise differences in controls. Conclusion 4D CT images revealed differences in jaw function between patients who underwent mandibular reconstruction and controls. 4D CT could be used to evaluate postoperative outcomes following mandibular reconstruction.

DOI： 10.1016/j.jcms.2016.01.027

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Head and Neck  

Background The purpose of this study was to analyze outcomes for the treatment of locally advanced temporal bone cancer by means of concomitant chemoradiotherapy (CCRT) with a combination of cisplatin (CDDP), 5-fluorouracil (5-FU), and docetaxel (TPF). Methods Between 2006 and 2011, 34 patients with squamous cell carcinoma of the temporal bone were treated at Kobe University Hospital. Medical records were retrospectively reviewed to obtain information concerning patient characteristics, extent of disease, treatment, adverse events, and oncologic results. Results Ten patients were treated with CCRT using TPF regimen. The 5-year overall survival rate and disease-free survival rate were both 60%. Of special interest is that even for patients with unresectable T4 disease, the 5-year overall survival rate was 56%. Conclusion The results of our study indicate that CCRT with TPF for locally advanced temporal bone cancer is an effective and promising regimen.

DOI： 10.1002/hed.24133

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記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology  

Objective: This study aimed to compare postoperative outcomes between free-flap reconstruction and prosthesis after secondary healing for moderate-sized maxillectomy defects. Methods: We enrolled patients who underwent tumor ablation extending to the alveolus, antral walls, masticatory space, and surrounding soft tissue but not the orbital floor with either radial forearm free-flap reconstruction (RFFF) or no reconstruction (NR) and compared the extent of cheek concavity on the resected side, evaluated using axial computed tomography images, and time to prosthesis insertion between the RFFF and NR groups. Results: There was a significant difference between the RFFF and NR groups in operative duration (P = 0.010) but not blood loss. The postoperative cheek concavity was significantly smaller in the RFFF group (P = 0.037). Although the between group difference in time to prosthesis insertion was not significant, prostheses tended to be inserted earlier in the RFFF group; median time to prosthesis insertion was 49 days in the RFFF group and 67 days in the NR group. Conclusions: Reconstruction of a moderate-sized maxillectomy defect with radial forearm free-flap transfer can improve postoperative outcome.

DOI： 10.1016/j.ajoms.2015.08.007

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本乳房オンコプラスティックサージャリー学会  

<p>　常勤形成外科医が不在の施設で, 形成外科医が非常勤として乳房一次再建に取り組んだわれわれの方法を紹介するとともに, 連携における問題点について検討し, 報告する。連携方法としては, 常勤形成外科が不在の2施設において, 乳腺外科の診察時に, 患者がある程度再建手術に関心があれば, おもに電子メールによりその情報が非常勤の形成外科医に伝えられ, 手術日程の候補日を検討した。術前に当該施設で全患者の診察を形成外科医が行った。再建手術を行ったのは28例30側で, 平均年齢は46.1歳, 再建術式は自家組織による再建19例19側 (有茎広背筋皮弁18例, 有茎横軸型腹直筋皮弁1例) , ティッシュエキスパンダー挿入が9例11側であった。形成外科の初診から手術までの日数は, 平均26.0±14.9日であった。電子メールの利用により連携は比較的スムーズであった。本連携では再建術式が限定されるため, 術式決定には, 形成外科医の診察およびインフォームド・コンセントが必須である。</p>

DOI： 10.20699/jopbs.1.2_82

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Brachial Plexus and Peripheral Nerve Injury  

In the treatment of the soft tissue defect of the elbow, flap reconstruction is necessitated in many cases because of thinness of soft tissue at this region. In addition, reacquirement of tactile sensation is desirable because of the anatomical and specific functions of the elbow. Of three cases treated for elbow defects, one was reconstructed with a pedicled island forearm flap containing the lateral cutaneous nerve of the forearm, another was reconstructed with a venoneuro-accompanying artery fasciocutaneous flap (VNAF flap) containing the basilic vein, and the third with the VNAF flap containing the cephalic vein. The three cases demonstrated a sudden change of sensory territory 4 to 6 months after surgery, which was confirmed by touching the reconstructed region with patients' eye-closed: from its original territory to the elbow in a "switching"-like action. Here we describe and discuss the concept of "sensory switching".

DOI： 10.1055/s-0035-1549369

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PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Implant Dentistry  

Background: Dental rehabilitation with osseointegrated implants in reconstructed mandibles remains one of the most challenging procedures for oral and maxillofacial surgeons. Satisfactory outcome requires appropriate assessment of graft morphology. There are few analyses of the morphology of fibulae in reconstructed mandibles, although cadaver studies on fibular shape have been performed. Materials and Methods: In this study, we used postoperative computed tomography to retrospectively evaluate the shape, height, and orientation of fibulae transferred after mandibulectomy in 19 patients. Results: The average height of transferred fibulae was 14.3 mm (range, 10.8'20.5 mm). The crosssectional morphology of transferred fibulae could be classified into 2 types: apex and nonapex. The former type included knife-edged and triangular shapes; the latter included square and circular shapes. Conclusion: When implant insertion is planned in a reconstructed mandible, the orientation of the apex of transferred fibula should be evaluated preoperatively to allow for adjustments in implant procedure because the ridge at the apex of the fibula is narrow.

DOI： 10.1097/ID.0000000000000290

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PubMed

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Oral and Maxillofacial Surgery  

The purpose of this study was to sequentially evaluate bone union of fibular grafts in mandibular reconstruction. Patients who underwent routine follow-up computed tomography (CT) and panoramic X-ray imaging during a period of ≥2 years were enrolled. On panoramic X-ray images, bone union was scored as 0 (absent callus formation) or 1 (complete callus formation). On CT images, a scale of 0 to 2 was used (0, absent callus formation; 1, complete callus formation only on the labial side; 2, complete callus formation on both the labial and lingual side). A total of 56 bone junctions were evaluated in 20 patients. Five of 56 junctions (9%) in four of 20 patients (20%) showed radiological non-union (panoramic X-ray score = 0, CT score = 0 or 1) at 2 years after surgery. All bone junctions with radiological non-union were located at the mandibular angle. No categorical values, including diabetes mellitus and radiation therapy, were significantly associated with radiological non-union. In conclusion, assessing at least two sides (i.e. labial and lingual sides) on CT images is adequate to evaluate bone union in transferred fibula flaps. Careful fixation at the mandibular angle may improve the rate of bone union.

DOI： 10.1016/j.ijom.2015.04.014

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Oral and Maxillofacial Surgery  

Purpose: Tissue that is resected for the treatment of oral tumors often includes salivary gland ducts. At their institution, the authors conserve and transfer as much of the salivary duct as possible during these procedures to avoid obstructive complications. Differentiating these obstructive complications from a metastatic node can be challenging and can confound subsequent oncologic management. This study compared and examined the effectiveness of salivary duct repositioning in decreasing the incidence of obstructive complications. Materials and Methods: Cases of oromandibular disease treated with salivary duct resection at Kobe University Graduate School of Medicine from 2008 to 2013 were retrospectively analyzed. Thirty-two cases (25 patients) of Wharton duct resection and 31 cases (31 patients) of Stensen duct resection were included. The incidence of complications after salivary duct repositioning, duct ligation, and retention of the sublingual gland around the Wharton duct was compared. Results: Wharton ducts were repositioned in 30 cases and ligated in 2 cases. Complications, including oral swelling at the Wharton duct, were observed in 5 cases of repositioning and 2 cases of ligation. Stensen ducts were repositioned in 9 cases and ligated in 22 cases. The only complication reported was a single case of salivary fistula after ligation. Conclusions: Salivary duct repositioning is performed to prevent blockage of physiologic salivary discharge. Complications were more frequently associated with Wharton ducts than with Stensen ducts because of the unique physiologic and anatomic characteristics of the Wharton duct. Repositioning of the salivary duct is a suitable method for preventing complications associated with the Wharton duct.

DOI： 10.1016/j.joms.2014.12.006

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

出版者・発行元：The Journal of craniofacial surgery  

DOI： 10.1097/SCS.0000000000001509

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PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Reconstructive Microsurgery  

Background Most free flap reconstruction complications involve vascular compromise. Evaluation of vascular anatomy provides considerable information that can potentially minimize these complications. Previous reports have shown that contrast-enhanced computed tomography is effective for understanding three-dimensional arterial anatomy. However, most vascular complications result from venous thromboses, making imaging of venous anatomy highly desirable. Methods The phase-lag computed tomography angiography (pl-CTA) technique involves 64-channel (virtually, 128-channel) multidetector CT and is used to acquire arterial images using conventional CTA. Venous images are three-dimensionally reconstructed using a subtraction technique involving combined venous phase and arterial phase images, using a computer workstation. Results This technique was used to examine 48 patients (12 lower leg reconstructions, 34 head and neck reconstructions, and 2 upper extremity reconstructions) without complications. The pl-CTA technique can be used for three-dimensional visualization of peripheral veins measuring approximately 1 mm in diameter. Conclusion The pl-CTA information was especially helpful for secondary free flap reconstructions in the head and neck region after malignant tumor recurrence. In such cases, radical dissection of the neck was performed as part of the first operation, and many vessels, including veins, were resected and used in the first free-tissue transfer. The pl-CTA images also allowed visualization of varicose changes in the lower leg region and helped us avoid selecting those vessels for anastomosis. Thus, the pl-CTA-derived venous anatomy information was useful for exact evaluations during the planning of free-tissue transfers.

DOI： 10.1055/s-0034-1400070

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Otolaryngology - Head and Neck Surgery  

Background: C-reactive protein (CRP) screening has been reported to be reliable for detection of infectious complications. Postoperative abnormal response of CRP can predict wound infection in colorectal surgery. This study aimed to determine the efficacy of CRP monitoring to detect infectious complications in oral oncologic surgery. Methods: One hundred patients who underwent oral cancer resection with primary reconstruction were enrolled. Postoperative kinetics of CRP were classified into a normal or abnormal response. Results: A normal CRP response after surgery was observed in 61 patients and an abnormal response was observed in 39. There were postoperative infectious complications in 21 patients, with surgical site infections in 13 patients (early onset in six and late onset in seven). Non-wound infections were found in nine patients. Sensitivity, specificity, the positive predictive value, and the negative predictive value for abnormal CRP response as a predictor for early infectious complications were 100%, 70.1%, 35.9%, and 100%, respectively. Conclusion: Postoperative serial CRP screening is a useful test as an indicator of infectious complications in oral oncologic surgery. Normal CRP responses can rule out almost all early infectious complications.

DOI： 10.1186/s40463-015-0066-6

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PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Craniofacial Surgery  

Previous studies on postoperative long-term results in patients who underwent reconstructive free flap transfer following hemiglossectomy had some issues, including the heterogeneity of the patient population and the observation period. The present study aimed to evaluate changes of reconstructed tongues in patients who underwent radial forearm free flap (RFFF) after hemiglossectomy with long-term follow-up. We enrolled 23 patients who underwent RFFF after hemiglossectomy with a postoperative follow-up of 5 years or more. Postoperative status (eating, speech, sensation function) was assessed by concise medical inquiries. Morphological changes of flaps were evaluated by reviewing clinical photographs. Hemiglossectomy involving the base of the tongue was performed in 4 cases (17.4%) and was limited to the mobile tongue in 19 cases (82.6%). The mean follow-up was 85.4 months (range, 60-122 months). All patients experienced gradually improved postoperative status. The most significant improvement was found between 1 and 5 years after surgery (P = 0.007), but not between 1 and 3 years (P = 0.075) or between 3 and 5 years (P = 0.530). In almost all of the flaps, there were few morphological changes throughout the follow-up period. Postoperative status in patients who underwent reconstructive RFFF following hemiglossectomy improved sequentially.

DOI： 10.1097/SCS.0000000000001176

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PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本口腔腫瘍学会  

われわれは，頭蓋顎顔面の形態的非対称は人間であれば必ず存在し，むしろ軽度の非対称が正常であるという計測学的事実と人間の視覚的非対称識別能力という二つの観点から顎顔面非対称を分類してきた。今回，この分類法をベースに，顎顔面非対称患者の術後における自己認識に影響を与える因子を見いだし，下顎再建への応用を試みた。さらに，これら因子と移植骨の吸収，そして末梢動脈疾患からみた腓骨の限界と絶対的適応症について検討した。過去19年間に神戸大学口腔外科，形成外科，群馬大学歯科口腔・顎顔面外科で腓骨皮弁により下顎区域再建された21例を対象とし，下顎欠損範囲と術後の整容性との関係について分析した。末梢動脈疾患（PAD）患者およびその予備軍における腓骨動脈温存の重要性については文献的に考察を行った。その結果，術後の非対称性認識，移植腓骨吸収さらに末梢動脈疾患（PAD）患者およびその予備軍における腓骨動脈温存の重要性等を考慮すると，遊離腓骨皮弁における下顎再建は，骨切りを要しない下顎直線部で，顎角部が温存された症例に限定され，それ以外では他の再建法を考慮する必要があると考えられた。

DOI： 10.5843/jsot.27.49

CiNii Research

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Artificial Organs  

Purpose: Acellular nerves are a reconstruction material and provide scaffolds for nerve regeneration. Numerous methods to develop acellular nerves have been described. However, these methods pose problems that can be attributed to incomplete acellular processing and destruction of the extracellular matrix (ECM); the former may lead to rejection response, while the latter may damage the scaffold. In order to overcome problems associated with the above-mentioned methods, we developed a novel method that employs a hypertonic sodium chloride solution to decellularize nerve graft material.

DOI： 10.5301/ijao.5000365

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Lower Extremity Wounds  

Diabetics with foot-related problems might eventually need to undergo major or minor amputation because of infection or cellulites. It has been suggested that immobilization of the ankle and the metatarsophalangeal joint suppresses the spread of infection; however, there is no evidence to support this inference. Here, we demonstrate by histological analysis how the immobilization works. The tendon from the amputated toe is harvested, and a hematoxylin-eosin stained paraffin-embedded section is prepared and analyzed. Necrosis occurred in only a single fiber of the tendon, and intact and necrotic or infected tendon fibers were found intermingled. The reciprocal movements of the tendon and the joint (extension and flexion) may be the pathogenic cause of cellulites and infection, leading to the massage effect and the spread of bacteria along the tendon itself. We suggest that immobilizing the ankle and the metatarsophalangeal joint with a removable contacting cast would suppress the spread of infection in foot ulcers.

DOI： 10.1177/1534734614545873

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Artificial Organs  

This study aims at the evaluation of blood vessel reconstruction process of decellularized small diameter vessels prepared by a hyperosmotic electrolyte solution treatment not only histologically but also physiologically in rat transplantation model. Complete cell removal by a hyperosmotic electrolyte solution treatment was confirmed by hematoxylin/eosin staining and scanning electron microscopic observation. All acellular vessels transplanted into the rat abdominal aorta were patent up to 14 months. One week post-transplantation, the vWF-positive cells were observed on the luminal surface but the layer formation did not complete. Five weeks following transplantation, the vWF-positive endothelial cells were located on the intima consistent with intact endothelial cells. Beneath the endothelial cells, α-SMA-positive smooth muscle cells were distributed. The harvested vessels displayed formation of tunica intima (endothelial cells) and tunica medulla (smooth muscle cell) layers. We also examined the physiological properties of the vessels 12 months post-transplantation using a wire myograph system. The transplanted vessels contracted upon addition of norepinephrine and relaxed upon addition of sodium nitroprusside as well as the native vessels. In conclusion, the acellular vessels prepared with hyperosmotic electrolytic solution showed excellent and long-term patency, which may be related to the successful preservation of vascular ECM. In addition, the acellular vessels revealed the intima/medulla regeneration with the physiological contraction-relaxation functions in response to the each substance. © 2014 The Japanese Society for Artificial Organs.

DOI： 10.1007/s10047-014-0760-6

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記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

DOI： 10.1155/2014/893746

PubMed

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Dermatologic Surgery  

Background Tumor thickness and relative depth of invasion are prognostic parameters considered when developing treatment plans for malignant skin tumors. Although conventional magnetic resonance (MR) imaging techniques cannot identify small tumors, use of microscopy coils considerably improves spatial resolution. Some studies have shown that this technique is efficacious in preoperative assessment of relative depth of invasion; however, its ability to provide accurate measurements of tumor thickness remains unconfirmed. Objective The purpose of this pilot study was to evaluate the usefulness of preoperative MR-microscopy in determining tumor thickness and relative depth of invasion of malignant skin tumors. Methods and Materials Magnetic resonance images of malignant skin tumors in seven female patients (six with basal cell carcinoma and one with malignant melanoma) were obtained using a 1.5 T system and a 47-mm or 23-mm microscopy coil. Tumors were then excised, fixed, dehydrated, embedded, and stained with hematoxylin and eosin. We then compared MR-microscopy and pathology values for thickness and relative depth of invasion of each tumor. Results Both techniques produced similar measurements of tumor thickness and relative depth of invasion. Conclusions MR-microscopy is very useful for accurate preoperative estimation of not only relative depth of invasion, but also thickness of malignant skin tumors. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

DOI： 10.1111/dsu.12371

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記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

Three-dimensional imaging with multidetector-row computed tomography (MDCT) provides useful information for the evaluation of arteries before an operation. However, the obtained information has been restricted only to arteries. We developed a phase lag-CT angiography (pl-CTA) method that allows three-dimensional visualization of the venous anatomy. The principle of pl-CTA is simple and consists of a phase lag and subtraction of images using a workstation. pl-CTA provides a greater amount of venous anatomical information compared to that obtained by the usual CTA.

Scopus

記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

Intractable cutaneous ulcers on the fingers are a common complication of systemic sclerosis (SSc). These are associated with pain and require daily treatment, which may decrease the quality of life of the patients. Digital ulcers (DUs) in the Proximal interphalangeal (PIP) joints can become intractable because the bone protrudes toward the dorsal side owing to joint flexion contracture, which induces poor circulation and persistently exerts pressure on the atrophic skin and subcutaneous tissues. In ulcers associated with a pocket, the shearing force of the joint movement, as in the case of decubitus ulcers, can also cause the ulcers to become intractable. Various treatment methods are available for vascular compromise, including pharmacotherapy, surgical revascularization, and local treatment in a moist environment; however, there are few reports of specific techniques to address the bony prominences and the shearing force. We performed fixation with a long-term-use, removable custom-made device on the palmar surfaces of the fingers, for (1) decompression of the dorsal subcutaneous tissues, (2) prevention of deviation due to joint stabilization, and (3) prevention of further flexion contractures. Herein, we report two cases of DU on the dorsal side of the PIP joint that was complicated with SSc, both of which had excellent outcomes following the use of this procedure.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Web of Science

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Microsurgery  

Introduction: Magnetic resonance angiography (MRA) is currently considered the most useful test to evaluate the vascular anatomy of the lower leg prior to free fibula osteocutaneous flap transfer. This study aimed to confirm the validity of preoperative MRA. Methods: In 19 patients underwent free fibula osteocutaneous flap transfer for maxillary and mandibular reconstruction, the MRA and intraoperative findings and the postoperative complications were retrospectively analyzed. The location and number of distal septocutaneous perforators (dSCPs) that were preoperatively identified and harvested with flaps were documented. Results: Preoperative MRA detected dSCPs with 100 % sensitivity. MRA findings also revealed the diversity of vascular structures, such as the tibio-peroneal bifurcation location and the anatomical relationship between the peroneal vessels and the fibula. No patients suffered postoperative ischemic complications in the donor leg. The total flap survival rate was 95 %. Conclusions: Preoperative MRA effectively excluded large vessel anomalies and peripheral vascular disease, and precisely identified the septocutaneous perforators. Additionally, preoperative MRA contributed to a safer fibular osteotomy by predicting the anatomical relationship between the peroneal vessels and the fibula. © 2013 Wiley Periodicals, Inc. Microsurgery 33:454-459, 2013. Copyright © 2013 Wiley Periodicals, Inc.

DOI： 10.1002/micr.22128

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記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Plastic Surgery  

Umbilical reconstruction after total excision of the umbilicus represents a challenging problem for reconstructive surgeons. We describe herein a new method for one-stage umbilical reconstruction after resection of a urachal cyst. This case series included 6 patients, with laparoscopic urachal cyst removal in 5 and conventional transcutaneous surgery in 1. One-stage umbilical reconstruction was performed in all cases. When a conventional transcutaneous approach is indicated, umbilical reconstruction can be undertaken through the same skin incision used for total resection of the urachal cyst. Two triangular flaps were designed just below the umbilical defect. Flaps were rotated 180 degrees and sutured together to form one big triangular flap. This flap was then folded to create the new umbilicus. A deep umbilicus with good shape was constructed in all cases, and all patients were satisfied with the outcome. This method is simple, easy, and produces a natural-looking umbilicus. Copyright © 2013 by Lippincott Williams & Wilkins.

DOI： 10.1097/SAP.0b013e318248b830

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出版者・発行元：Journal of Craniofacial Surgery  

DOI： 10.1097/SCS.0b013e3182953a0b

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PubMed

出版者・発行元：Journal of Craniofacial Surgery  

DOI： 10.1097/SCS.0b013e3182801898

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Craniofacial Surgery  

Ameloblastic carcinoma is a very rare malignant odontogenic tumor. We report a case of secondary-type ameloblastic carcinoma that extended transversally over almost half of the side of the face. Malignant transformation and identification of the malignant region in the large tumor were achieved using L-3-[F]fluoro-α-methyltyrosine (FAMT)-positron emission tomography (PET); FAMT is transported into cancer cells by L-type amino acid transporter 1 and shows high specificity for malignant tumors. The malignant region determined by microscopic evaluation of resected samples was similar to the region showing high FAMT uptake in PET. Using preoperative FAMT-PET and magnetic resonance imaging, we were able to achieve total resection of the very large tumor, while avoiding excessive resection that could cause severe functional loss or a poor aesthetic facial appearance. We used a modified Weber-Fergusson incision along the nasolabial fold to the labiajugal fold and reconstruction with a pectoralis major muscle flap, and this gave a good aesthetic outcome. Safe surgical resection was possible because preoperative three-dimensional computed tomography angiography was used to identify the position of the main trunk of the external carotid artery, which was closely aligned with the tumor in a posterior direction in the infratemporal fossa region. Copyright © 2013 by Mutaz B. Habal, MD.

DOI： 10.1097/SCS.0b013e3182710311

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Plastic, Reconstructive and Aesthetic Surgery  

Prevention of the atrophy of denervated muscles is essential for a good outcome in facial contouring and oral reconstruction. In this study, we compared the effectiveness of end-to-end and end-to-side neurorrhaphy of the motor nerve, and end-to-end neurorrhaphy of the sensory nerve, all of which are frequently used in such reconstruction for the prevention of muscle atrophy. Wistar rats were divided into four groups: group 1, motor nerve division of semi-membranosus without repair; group 2, motor nerve division and end-to-end coaptation to the saphenous nerve; group 3, motor nerve division and end-to-side coaptation to the sciatic nerve; and group 4, motor nerve division and end-to-end repair. Measurement of semi-membranosus volume, histological evaluation and staining of neuromuscular junctions that were carried out 3 months postoperatively revealed that muscle volume preservation was larger in groups 3 and 4 than in the other two groups (p < 0.05), but slightly superior in group 4 (p < 0.05). There was no statistical difference between groups 2 and 1; histologically, muscle architecture was better preserved in group 2 than in group 1; reactivation of the neuromuscular junctions was observed in all except group 1. End-to-side repair of motor nerves is one of the better options for the preservation of muscle volume when end-to-end nerve repair is not indicated. Sensory protection may also provide some advantages in the preservation of muscle volume. © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjps.2012.01.018

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

Ion beam therapy has lately attracted considerable attention as an effective means for beating cancers. Ion beam experts say that it produces less harmful side effects than regular radiation because of its physical features. Sometimes, however, it induces severe skin damage as a side effect. We experienced seven cases of intractable ulcerations associated with ion beam therapy. Original diseases of our cases are composed of three hepatocellular carcinomas, three soft tissue sarcomas, one squamous cell carcinoma in the head and neck region. From these seven cases, we found two important clinical features of the ulcerations due to ion beam. First, severe skin necrosis or ulcerations occur frequently when cancers are located shallowly in the body, for instance hepatocellular carcinoma and soft tissue sarcomas in the extremities. Second, the outbreak of ulceration after ion beam therapy is much earlier than that of chronic ulcerations after regular radiation therapy. Conservative therapy is not effective to cure the ulcerations. We should achieve sufficiently deep debridement and reconstruct the defect by a flap rich in blood supply.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）  

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語  

Web of Science

記述言語：英語   出版者・発行元：Japanese Journal of Head and Neck Cancer  

&lt;p&gt;We propose the &quot;CAT concept&quot;, a new theory for surgical reconstruction after oncological segmental mandibulectomy. The essence of the theory is to reconstruct three reference points on the mandible - &quot;C&quot; (condylar head) &quot;A&quot; (mandibular angle) and &quot;T&quot; - necessary and sufficient for its surgical reconstruction. An anthropometric analysis of the mandible of ten preserved human cadavers showed that the mandibular contour can be made merely 3 to 7 mm smaller than the original when the CAT concept is adopted, suggesting that the concept sufficiently satisfies the condition for surgical reconstruction of the mandible. A review of our 45 clinical cases of mandibular reconstruction after oncological ablation demonstrated a positive trend between the number of reconstructed or non-resected reference points of the CAT concept and the esthetic outcome of each patient (Fisher&#039;s exact test, p&lt;0.01), suggesting that the concept satisfies the necessary condition. Given these results, we concluded that the CAT concept is a highly practical theory for the surgical reconstruction of segmental mandibular defects.&lt;/p&gt;

DOI： 10.5981/jjhnc.38.84

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CiNii Research

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   出版者・発行元：北関東医学会  

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J03107&link_issn=&doc_id=20110825450129&doc_link_id=%2Fde3kitak%2F2011%2F006103%2F132%2F0462-0462%26dl%3D2&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fde3kitak%2F2011%2F006103%2F132%2F0462-0462%26dl%3D2&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_5.gif

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Auris Nasus Larynx  

Candida species inhabit the mucosal surfaces of healthy individuals. Major forms of oral candidiasis are pseudomembranous and atrophic form, but chronic hyperplastic candidiasis (CHC) is rarely seen. We encountered a nodule caused by candidal infection on a forearm flap in the oral cavity mimicking a recurrent tongue cancer, which revealed as CHC by histopathological examination. Like other forms of oral candidiasis, the nodule well responded to the treatment of antifungal agents and eventually disappeared. When an intraoral nodule is observed, the possibility of CHC should be taken into consideration. © 2010 Elsevier Ireland Ltd.

DOI： 10.1016/j.anl.2010.11.007

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記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Foot and Ankle Surgery  

The incidence of the diabetic foot is increasing worldwide. Because evidence has shown that transmetatarsal amputation is associated with fewer failures in amputations of the diabetic foot with or without peripheral arterial disease, improving its management and surgical technique is a mission for the surgeon. Conventional transmetatarsal amputation has held firm, however, for more than 150 years. With a new concept for the transmetatarsal amputation method aimed at a better outcome, we propose a modified procedure for preserving the soft tissue between the metatarsal bones (the vasculature complex with the muscles, periostea, and vessels) and applying it to the distal bone stumps. The purpose of this method is to secure a functional foot by preserving the longitudinal arch. The new method was applied to 11 patients with diabetes mellitus or peripheral arterial disease, or both. All wounds closed successfully. Of the 11 patients, 8 were still alive with no complications. Of these 8 patients, 6 were able to ambulate with a custom-made shoe and 2 used a wheelchair, just as preoperatively. Of the 3 patients who died, 1 died a natural death, 1 died of sepsis, and 1 of cerebral infarction. We believe that the modified transmetatarsal amputation that we have described in this report is a potential breakthrough in the care of patients with forefoot gangrene and may gain acceptance over time. © 2011 American College of Foot and Ankle Surgeons.

DOI： 10.1053/j.jfas.2011.03.018

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Reconstructive Microsurgery  

DOI： 10.1055/s-0030-1251562

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記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Head and Neck  

Background. Our objective was to evaluate the value of the blowing test to measure the speech and swallowing function after resection of oral or oropharyngeal cancer. Methods. Speech and swallowing functions of the patients after surgical resection of oral or oropharyngeal cancer were assessed by a speech intelligibility test, blowing time, questionnaires, and oropharyngeal pressures. Blowing time (pressure) ratio was determined by dividing blowing time (pressure) with open nose by blowing time (pressure) with closed nose. Results. Blowing time ratio had significant correlation with blowing pressure ratio (p = .014), score of speech intelligibility test (p = .0014), questionnaire for aspiration (p= .029), nasopharyngeal backflow (CC = 0.676, p = .032), amount of food to swallow (p = .037), and oropharyngeal pressure during swallowing (p = .024). Conclusion. The present results demonstrated the value of blowing time ratio as a simple objective tool for speech and swallowing ability related to velopharyngeal function after resection of oral and oropharyngeal cancers. © 2009 Wiley Periodicals, Inc.

DOI： 10.1002/hed.21283

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Plastic, Reconstructive and Aesthetic Surgery  

Harvesting the radial forearm flap may cause circulatory problems in the donor arm. To investigate the influence on donor hands after radial forearm flap harvesting, we assessed the process of circulatory changes prospectively by measuring skin perfusion pressure (SPP) that is clinically useful in detecting vascular lesions. The records of 17 patients (14 men and 3 women aged 59.7 ± 11.8 years) who had undergone free radial forearm flap transfer for head and neck reconstruction, between December 2005 and April 2007, were analysed. SPP in the thumb (finger I), the middle finger (III) and the little finger (V) was measured in the 17 patients preoperatively and 1 month and 3, 6, 9 and 12 months postoperatively. All statistical tests were two sided, with a significance level defined as p < 0.05. Preoperatively, baseline SPP was more dominant in finger I than in finger V. Postoperatively, SPP changed significantly in both fingers, while it showed no change in finger III and tended to be higher in finger I than in the other two. Harvesting the free radial forearm flap reduces skin perfusion in the fingers of the donor arm and, we assume, leads to a re-distribution of blood flow to the fingers, with the residual ulnar artery still supplying more blood flow to finger I than to finger V. This suggests the presence of an autoregulating mechanism whereby blood perfusion to the fingers is controlled by the physiological demands of individual fingers. © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons.

DOI： 10.1016/j.bjps.2008.11.068

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語  

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記述言語：日本語   出版者・発行元：(株)全日本病院出版会  

縫合糸や皮膚閉鎖に用いる材料の特性を十分に理解することは'キズアトをきれいにする'ために重要である。たとえ縫合技術が一流であっても、材料に対する理解が不十分であれば良好な結果を得ることはできない。瘢痕形成を考慮すると、組織反応が少なく、抗張力の持続するモノフィラミント合成非吸収糸であるナイロン糸を用いた真皮縫合が主流であった。しかし近年、長期間抗張力を維持する吸収糸が開発され、真皮縫合に使用される機会が増えてきた。長期的な縫合糸膿瘍、糸露出の危険性を考慮すると、PDS IIなどの抗張力の持続するモノフィラメントの合成吸収糸は有用である。真皮縫合の後、創縁の微妙な修正やズレの防止のために、縫合糸を用いた表皮縫合を行う。皮下縫合、真皮縫合で創縁がしっかりと外反、密着している状態では、表皮縫合をせずに皮膚表面接着剤、サージカルテープや半透過性透明フイルムも(1)抜糸の必要がない、(2)針糸刺入による組織損傷がない、(3)手術時間の短縮が可能、(4)縫合糸痕の心配がない、という点で有用な皮膚閉鎖法である。本稿では、真皮縫合に用いる縫合糸の選択および表皮縫合の方法について詳述する。(著者抄録)

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Oral and Maxillofacial Surgery  

Purpose: Various autografts and synthetic materials such as titanium plates have been used for orbital floor reconstruction; however, no consensus on reconstruction methods has been reached. We have used iliac cancellous bone for this reconstruction with good results. Patients and Methods: Patients (n = 101) enrolled in this study underwent orbital floor reconstruction of pure blowout fracture with an approximate 1 mm thinned and trimmed iliac cancellous bone without fixation of the graft. The results were assessed by CT; diplopia exceeding an angle of 45 degrees was evaluated as a poor outcome. Results: Postoperatively, diplopia appeared in 15 patients and disappeared in 86 patients. At 6-month follow-up, CT showed that the morphology of the orbit was well maintained and no shedding or improper positioning of the grafted bone was observed in any of the patients. Moreover, CT images demonstrated ossification of the transplanted bone graft. Conclusions: The method encompassing the use of the medulla of the iliac bone has several merits: 1) the graft bone is sufficiently pliable and flexible to fit the gently curving orbital floor; 2) being soft, it is easy to cut. Furthermore, no complication attributable to its fragility is observed at short- and long-term follow-up. The 1 mm thin medullar bone graft derives its robustness from its beamed structure. We consider the medulla of the iliac bone fitting autosomal material for the reconstruction of the orbital floor. © 2009 American Association of Oral and Maxillofacial Surgeons.

DOI： 10.1016/j.joms.2008.08.014

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

The process of the ischium may be a risk factor for intractable pressure ulcers, as is the process of the sacrum. How the ischium affects pressure ulcers is the subject of controversy, however, because little is known about the shapes of ischia with pressure ulcers. With 3-dimensional computed tomography (3D-CT), we assessed the extent of the prominence of the ischium and free bone fragments of eight patients with ischial ulcers who required surgery. In 6 out of 9 patients (67 %) the ischia of the side with pressure ulcers were less prominent than, and in 3 patients ischial bones of the side with pressure ulcers were as prominent as, the other side, demonstrating that in no case is the ischium of the side with the pressure ulcer more prominent than the other side. In the sitting position, the pelvis tends to lean toward the side of the less prominent ischium. Ischial pressure ulcers may be intractable because of the leaning, which increases interface pressure on the side of the pressure ulcer.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

When a surgeon treats a distal foot ulcer accompanying exposure of the bone or joint, reverse flow flap from the dorsal foot is a useful maneuver to employ. Reverse flow flaps are very useful for the reconstruction of distal extremities; however, venous congestion of the flap may occur. Although various theories of reverse venous drainage have been reported, the safety and certainty of reverse flow flap have not been verified. In this report, we use the reverse flow flap from the dorsal foot to treat distal foot ulcers. We performed venous anastomosis to persuade postoperative venous drainage antegradely. We present two case reports and discuss the reliability of venous anastomosis in reverse flow flap surgery.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

We have to reconsider the selection of operative methods for decubitus on calcaneal regions, unlike the reconstructive operative methods for the loading region on feet. This is because it depends upon the pathogenesis of decubitus, sensory level, and/or ambulatory condition whether the wound has the operative indication. We here classify the decubitus on calcaneal region into three patterns. 1. Bedfast patient 2. Diabetes mellitus (DM) and/or peripheral arterial disease (PAD) 3. Ambulatory paralytic patient.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   出版者・発行元：Japanese Journal of Plastic Surgery  

Sclerotherapy for venous malformation is thought to be a simple, relatively safe, minimally invasive treatment that leaves no scars. Its effectiveness has often been reported, and it is the standard treatment in Japan. Here, we investigated the usefulness of simulation cavernography and sclerotherapy for venous malformation. We retrospectively analyzed 80 sclerotherapy sessions of 42 patients diagnosed with venous malformation and treated by sclerotherapy at Kobe University Hospital and in the Division of Plastic Surgery, National Hospital Organization Himeji Medical Center, from April 2000 to October 2006. The results of fluoroscopy were classified into four types according to the following procedures. Type I : Pooling of contrast medium in the cavity of the venous malformation was confirmed, and sclerotherapy was conducted continuously (50 sessions, 62.5%). Type II : A thick drainage vein was confirmed, another part was punctured, and sclerotherapy was conducted continuously (8 sessions, 10.0%). Type IIIa : A thick drainage vein was confirmed, and sclerotherapy was carried out by manually pressing the vein to prevent the sclerosant from flowing into the drainage vein (21 sessions, 26.3%). Type IIIb : A thick drainage vein was confirmed, another part was punctured, but sclerotherapy was discontinued (1 session, 1.25%). Had we carried out sclerotherapy without simulation cavernography, some side effects would probably have ensued in 37.5% of the cases. The results suggest that simulation cavernography and sclerotherapy are useful in the treatment of venous malformation.

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記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Reconstructive Microsurgery  

Regions of oropharyngeal cancer, hypopharyngeal cancer, and cervical esophageal cancer in a 70-year-old man were surgically resected and reconstructed with a free jejunal flap. Postoperatively the patient showed severe dysphagia and a chimneylike protrusion in the oral cavity. In a second operation, a dorsal, longitudinal incision for phimosis was made to release the stenosis; however, the dysphagia persisted, and peristalis seemed to interfere with deglutition. Here, we discuss the cause of the dysphagia, a complication of total reconstruction of oroesophageal defects with a single free jejunal flap, and the procedures of reconstruction. Copyright © 2008 by Thieme Medical Publishers, Inc.

DOI： 10.1055/s-2008-1076092

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   出版者・発行元：日本シミュレーション外科学会  

血管奇形に対する硬化療法に術中シミュレーションを導入し、その成績を報告した。対象は静脈奇形に対して硬化療法を施行し、造影記録を確認できた15症例(男性7名、女性8名)で、これらの症例に対して合計33回の治療を行った。術中シミュレーションの結果は以下の4タイプに分類した。造影剤が病変内に留まり、そのまま硬化療法を施行した症例(タイプ1,82%)。太い流出静脈や主要血管への流出が確認され、穿刺部位を変えて硬化療法を施行した症例(タイプ2,15%)。用手的圧迫で病変内に留まり、硬化療法を施行した症例(タイプ3a,0%)。用手的圧迫でも病変内に留まらず、硬化療法を断念した症例(タイプ3b,3%)。タイプ3aは硬化療法施行時にしばしば経験するが、今回の症例中では見られなかった。タイプ2と3bを併せると18%の症例で流出静脈を認めたが、いずれの症例も重篤な合併症は見られず、経過は良好であった。

記述言語：英語  

Web of Science

記述言語：日本語   出版者・発行元：Japanese Journal of Plastic and Reconstructive Surgery  

We describe two cases of hemilateral lower lid retraction in thyroid ophthalmopathy surgically treated with comprehensive lid interlining cartilage (CLIC) grafts, whereby the total lower lid is supported by 4.5×1 cm auricular cartilage. Case 1 : A 74-year-old man visited our department presenting with right lower lid retraction (4 mm lower than the contralateral side), The patient had three months earlier undergone right inferior rectus muscle recession to treat double vision. A CLIC graft to his right lower lid was carried out under local anesthesia. Case 2 : A 44-year-old man with right lower lid retraction (3 mm lower than the contralateral side) had 12 months earlier undergone right inferior rectus muscle recession. The patient underwent a CLIC graft under general anesthesia. In both cases, the retracted lower lid was corrected and restored to the level of the contralateral side I also, a natural symmetrical appearance of the mid-face was attained. CLIC grafting is an effective alternative treatment for lower lid retraction in thyroid ophthalmopathy patients.

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記述言語：日本語   出版者・発行元：(一社)日本創傷治癒学会  

掲載種別：研究論文（学術雑誌）   出版者・発行元：Dermatologic Surgery  

DOI： 10.1111/j.1524-4725.2007.33294.x

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記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Dermatologic Surgery  

We have demonstrated a simple and easy method of dressing free skin grafts with the use of two sheets of polyurethane foam and film. The whole procedure can be carried out within 20 minutes without an assistant. The dressing is removed several days after the surgery and, if necessary, the same procedure can be repeated at bedside without anesthesia. Good results were obtained with this method applied to 25 patients. © 2007 by the American Society for Dermatologic Surgery, Inc.

DOI： 10.1111/j.1524-4725.2007.33202.x

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記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：英語   出版者・発行元：Plastic and Reconstructive Surgery  

BACKGROUND: In treating patients with anophthalmic orbits, it is essential to achieve a long-lasting natural appearance and comfortable retention of eye prostheses. In 1992, the authors developed a therapeutic strategy based on a simple algorithm for treating the three common symptoms of acquired anophthalmic orbit: severe eye socket contracture is surgically treated with a radial forearm free flap transfer, upper lid depression is treated with lipoinjection, and lower lid retraction is treated with an auricular cartilage graft. METHODS: From 1992 to 2004, 18 acquired anophthalmic orbits (11 enucleated and seven exenterated) were treated at Kobe University Hospital based on the authors' therapeutic strategy. Aesthetic outcomes were evaluated according to patient and surgeon satisfaction. RESULTS: Sixteen patients underwent auricular cartilage grafts, eight received radial forearm free flap transfers, and seven were treated with lipoinjection. Optional revisional surgery was carried out in four cases. The aesthetic outcome was assessed as good in six patients, moderate in eight patients, and poor in four patients; the last four had undergone total maxillectomy with orbital exenteration or had eyelid defects because of previous cancer surgery. CONCLUSIONS: The authors' therapeutic strategy for acquired anophthalmic orbit is simple and, with slight modification, fitting for most cases, although it necessitates innovative surgery in cases with orbital rim and/or eyelid defects. ©2007American Society of Plastic Surgeons.

DOI： 10.1097/01.prs.0000260706.07368.f1

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記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：日本語   掲載種別：研究論文（国際会議プロシーディングス）  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Dermatology  

There have been few reports about the characteristics of the pigmentary arrangement of congenital melanocytic nevi (CMN) and nevus spilus (NS). Though the lines of Blaschko, which don't correspond to other lines such as Langer's lines and skin dermatomes, are well known to be followed by some rare pigmentary disorders, the relationship between these two disorders and the lines of Blaschko has not been discussed. Therefore, through an examination of 200 cases, we investigated whether or not the arrangement of CMN and NS follow the lines of Blaschko. Thirty-nine out of 92 cases (42.4%) of CMN and 67 out of 108 cases (62.0%) of NS were considered to follow the lines of Blaschko. Today, the idea is widely accepted that two functionally different cells proliferate during early embryogenesis of the skin which is caused from mosaicism and, as a result, the lines of Blaschko appear visually. In our results, we found that there were some cases of CMN and NS which showed a relationship with the lines of Blaschko, which is meaningful considering that the lesions and the lines are both related to pigmentary gene anomalies. The result was compared with CMN and NS by the χ2 test. NS showed a predominant tendency to follow the lines with a significant difference (P = 0.0055). This may indicate that the lines of Blaschko reflect more clearly the proliferation of the epidermal cells than other cells in growth of the skin of the embryo. Further studies are required to elucidate the reason why some cases follow these lines and others do not. © 2007 Japanese Dermatological Association.

DOI： 10.1111/j.1346-8138.2007.00242.x

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Plastic, Reconstructive and Aesthetic Surgery  

Background: In patients with perianal extramammary Paget's disease, wide local excision is recommended. In the reconstruction of the resulting large defects not only the closure of the defect but also the preservation of anogenital function need to be considered. Methods: We used bilateral V-Y advancement posterior thigh fasciocutaneous flaps for reconstructing three large anogenital defects, including the total anal canal, resulting from wide local excisions attributed to extramammary Paget's disease. A temporary anus was constructed at the same time to allow the wound of the reconstructed anus to heal. After the surgery, the course of bowel function was followed up through interviews and manometric examinations. Results: All defects were successfully reconstructed with the flaps, and bowel function recovered satisfactorily. Manometric examinations were carried out in two cases; anal pressures were recorded regularly and used as parameters of the recovery of bowel function before closing the artificial anus. Eventually, the patients recovered the function of defecation. Conclusions: We recommend the bilateral V-Y advancement posterior thigh fasciocutaneous flaps together with manometric studies as one of the most effective techniques for managing large anogenital defects. The use of sensate flaps, the restoration of original structures and manometric studies are conducive to successful outcomes. © 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons.

DOI： 10.1016/j.bjps.2007.02.005

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   出版者・発行元：Kobe Journal of Medical Sciences  

Old malunited jaw fractures of nine patients who underwent orthognathic surgery for occlusal reconstruction were clinically evaluated. Early surgery on fractures of the jaw is the optimal treatment when due attention must be paid to occlusion. Since occlusal revision surgery subsequent to inaccurate diagnosis and inappropriate surgery is certainly very difficult and often unsuccessful, surgeons need to pay special attention to this situation.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Plastic and Reconstructive Surgery  

BACKGROUND: Reconstruction of eye globe-sparing total maxillectomy defects is one of the major challenges to reconstructive surgeons. In 1994, the authors developed an uncomplicated and easy reconstructive method, where a titanium mesh is applied for the support of orbital contents, a radial forearm free flap for covering the mesh and the cheek lining, and an obturator prosthesis for palatal and dental rehabilitation. METHODS: Five patients who underwent primary reconstruction with the authors' method after globe-sparing maxillectomy with loss of the orbital floor from 1994 to 1999 and who were followed up for more than 5 years were retrospectively reviewed for (1) the presence of diplopia, (2) the shape of the reconstructed orbital floor assessed by coronal section magnetic resonance imaging, and (3) the presence of infection/exposure of the titanium mesh. RESULTS: Only one of the five patients developed slight diplopia. Coronal magnetic resonance imaging showed that the orbital floor restored with titanium mesh had in all cases maintained a proper shape and position for more than 5 years. No infection or exposure of the titanium mesh had developed in any of the cases, despite exposure to irradiation of not less than 30 Gy. All the patients had well-retentive obturator prostheses. CONCLUSION: This long-term follow-up study demonstrated that the authors' method attained a long-lasting successful outcome functionally and is the method of choice for reconstruction after globe-sparing total maxillectomy. Copyright ©2006 by the American Society of Plastic Surgeons.

DOI： 10.1097/01.prs.0000200623.91956.66

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出版者・発行元：神戸大学  

Old malunited jaw fractures of nine patients who underwent orthognathic surgeryfor occlusal reconstruction were clinically evaluated. Early surgery on fractures of thejaw is the optimal treatment when due attention must be paid to occlusion. Sinceocclusal revision surgery subsequent to inaccurate diagnosis and inappropriate surgeryis certainly very difficult and often unsuccessful, surgeons need to pay special attentionto this situation.

PubMed

出版者・発行元：日本頭頸部癌学会  

神戸大学および関連施設では,これまで約600例に対して遊離前腕皮弁を用いた再建手術を行ってきており，これらの臨床例を対象に基礎的・臨床的研究を積み重ねてきた。皮弁挙上および血管吻合，採取部への植皮に関してこれまでに得られた知見と臨床への応用は下記の通りである。<BR>1）肘窩のperforating veinを血管茎に含めることで，深部静脈系と皮静脈系を連結させた皮弁挙上が可能となる。<BR>2）前腕皮弁の静脈還流は深部静脈系が優位であるため，静脈吻合の際は深部静脈系の血流を移植床に還流させる。<BR>3）皮弁の2系統の静脈を移植床の2系統の静脈と吻合し，それらをperforating veinで交通させることにより，より生理的なネットワーク型の静脈還流が可能となる。<BR>4）含皮下血管網植皮で皮弁採取部を被覆すれば整容的に優れる。<BR>5）ポリウレタンフォームとポリウレタンフィルムを用いることで，簡便かつ短時間に，術者一人で植皮固定を行える。

DOI： 10.5981/jjhnc.32.247

出版者・発行元：Plastic and Reconstructive Surgery  

DOI： 10.1097/01.PRS.0000153233.87258.5D

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DOI： 10.1097/01.PRS.0000148447.33144.14

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of oral science  

This study reviews reconstruction of complex three-dimensional oral and maxillofacial defects using the single free radial forearm flap or the single free rectus abdominis musculocutaneous flap. Between 1996 and 2003, 124 patients underwent oral and maxillofacial reconstruction in the Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine. Outcomes for 22 patients who underwent three-dimensional reconstruction of multiple surfaces were evaluated. Reconstruction was performed after resection of malignant tumors in all 22 patients. Single FAFs were utilized for 11 patients and single RAMs for the remaining 11. Flap survival rate was 100%. No major donor morbidity was observed, and all surviving patients (20/22) were able to perform normal daily living activities. Single FAF and RAM are useful materials for one-stage reconstruction of complex three-dimensional oral and maxillofacial defects requiring replacement of skin, mucosa, and intervening soft tissues. Good to excellent aesthetic results can be attained in most patients.

DOI： 10.2334/josnusd.46.65

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CiNii Research

記述言語：日本語   出版者・発行元：Annals of Plastic Surgery  

Whether or not multiple venous anastomoses reduce the risk of free-flap failure is a subject of controversy. We report here, for the first time, on the importance of selecting 2 separate venous systems of the flap for dual anastomoses. The efficacy of multiple anastomoses was verified through a retrospective review of 310 cases of the free radial forearm flap transfer. Dual anastomoses of separate venous systems (the superficial and the deep) showed a lower incidence of venous insufficiency than single anastomosis did (0.7% versus 7.5%; P < 0.05). On the other hand, dual anastomoses of a sole venous system showed no significant difference in the incidence of venous insufficiency compared with single anastomosis (11.5% versus 7.5%; P = 0.48). Our results suggest that dual venous anastomoses of separate venous systems is conducive to reduced risk of flap failure and affords protection against venous catastrophe through a self-compensating mechanism that obviates thrombosis of either anastomosis.

DOI： 10.1097/01.sap.0000096425.18223.60

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/S0266-4356(03)00170-0

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PubMed

記述言語：日本語   出版者・発行元：Plastic and Reconstructive Surgery  

Endoscopic endonasal reductions have been addressed in 63 patients with blowout fracture of the medial orbital wall since 1992. The operations were carried out under general anesthesia with a magnified operative space projected on a television monitor by a charge coupled device video camera attached to the endoscope. The middle nasal turbinate was fractured toward the nasal septum, the uncinate process was cut off, and the bulla was opened. The ethmoidal bony partition and the mucous membrane were removed; however, the fractured bone chips of the medial orbital wall were preserved. The herniated orbital contents were pressed back into the orbital cavity, and the medial wall was set with 2-mm-thick bent silicone plates placed in the ethmoidal sinus. The plates were removed in the outpatient clinic 2 months after the operation. The surgical results of 21 patients treated with endoscopic reduction were compared with those of four patients treated with transfacial reduction with an iliac bone graft. All of the patients had isolated medial wall fracture and became aware of diplopia within 15 degrees in any direction from the primary position (straight gaze) before the operation; the follow-up period covered 6 months. The patients were classified into two categories according to postoperative double vision: "good," indicating no double vision or diplopia of more than 45 degrees, and "poor," diplopia of less than 45 degrees. Improvement of diplopia was observed in all patients without any complication. Of the 21 patients who underwent endoscopic reductions, 17 were classified as "good" and four as "poor." On the other hand, of the four patients who underwent transfacial reductions, three were classified as "good" and one as "poor." Significant differences were not observed between the surgical results of our two methods. Endoscopic endonasal reduction showed greater aesthetic advantages and, moreover, required no grafting. This technique is suggested as one of the most reasonable treatments of medial orbital wall fractures.

DOI： 10.1097/01.PRS.0000080723.29129.64

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Cranio-Maxillofacial Surgery  

We describe a very rare case of midface fracture where the zygomatic bone had been completely avulsed. The fragment was preserved in a frozen state for 40 days, then replanted and the graft was taken. The conditions favourable for the taking of the freeze-preserved zygomatic graft were: (1) an appropriate preservation method, (2) conservation of the periosteum on the zygomatic bone, (3) diversity of the haemodynamics of the zygomatic membranous bone, (4) immobilization of the zygoma by rigid fixation, and (5) a rich blood supply at the recipient site. © 2002 European Association for Cranio-Maxillofacial Surgery.

DOI： 10.1016/S1010-5182(02)00183-X

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DOI： 10.1080/-2844310310007746

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記述言語：日本語   出版者・発行元：Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery  

The free radial forearm flap has two drainage veins, the cutaneous and the deep, but no established consensus has been reached on the selection of the drainage pedicle. In our study, the flow volumes of the veins were examined by colour Doppler ultrasonography after 20 forearm flaps had been raised. The volume through the deep vein was significantly higher than that through the cutaneous vein (p < 0.01). In comparing the total flow (both veins open), the flow rate through the deep vein alone (cutaneous vein occluded) was over 80% in 13 cases, 60%-80% in seven, and under 60% in none; that through the cutaneous vein alone (deep vein occluded) was 60%-80% in eight, 40%-60% in eight, under 40% in four, and over 80% in none. Our results show the importance of the deep vein, as indicated by its high drainage capacity from the early stages of flap transfer.

DOI： 10.1080/2844310310007746

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記述言語：日本語   出版者・発行元：Aesthetic Plastic Surgery  

Some techniques for the treatment of mandibular protrusion with consideration for aesthetic improvement of the face as a whole are described. The aesthetic inferiority complex in the mind of patients with masticatory disorders as the chief complaint should not be underestimated. Three techniques were used in this study; preoperative orthodontic treatment, preservation of the patient's self-image, and maintenance of beautiful relationship between the midfacial line and the nasolabial fold as well as the nasal ala.

DOI： 10.1007/s00266-002-2036-4

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記述言語：日本語   出版者・発行元：British Journal of Oral and Maxillofacial Surgery  

The mobile tongue and the suprahyoid muscles were reconstructed in a man who had had a total resection of the mobile tongue with the oral floor and bilateral radical neck dissection (extensive resection of the bilateral suprahyoid muscles) for cancer of the tongue. A rectus abdominis musculocutaneous flap with the tenth intercostal nerve anastomosed to the remaining hypoglossal nerve was used for the reconstruction. The rectus abdominis muscle was inserted between the mandible and the hyoid bone, taking account of the anatomical positions of the tongue and suprahyoid muscles; the rectus sheath was then firmly sutured to the mandible and hyoid bone. This procedure created firm tendinous insertions between the mandible and hyoid bone. After the operation, the reconstructed tongue showed no sign of atrophy, and the reconstructed suprahyoid muscles (rectus abdominis muscle) could be moved, and the hyoid bone could be raised. © 2001 The British Association of Oral and Maxillofacial Surgeons.

DOI： 10.1054/bjom.2001.0636

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