Publications by authors named "Satoshi Yurugi"

30 Publications

  • Page 1 of 1

Squamous cell carcinoma developed in a chronic radiation-induced chest wall ulcer that is difficult to undergo thorough preoperative histological examination.

Int J Surg Case Rep 2020 17;72:467-470. Epub 2020 Jun 17.

Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan.

Introduction: We report a case in which squamous cell carcinoma (SCC) developed in a large chronic radiation-induced thoracic ulcer after flap surgery in areas where preoperative histological examinations are difficult.

Presentation Of Case: The patient was a 75-year-old female. She had undergone resection and radiotherapy for left breast cancer 15 years earlier. Six years ago, the ulcer expanded from the subclavian to xiphoid levels, exposing the lung and pericardium. A histopathological examination, which avoided the lung and pericardium, was performed. Inflammation was diagnosed. We reconstructed the chest wall with a pedicled rectus abdominis flap. Eighteen months later, three verrucous tissue-lined fistulas formed. A histological examination revealed well-differentiated SCC. Six months later, the patient died of massive bleeding from a fistula.

Discussion: It is unclear exactly when the SCC occurred. As three fistulas formed at the margins of the flap around the pericardium, we suspect that the cancer developed within or near the pericardial region. We need to reflect on the lack of a thorough biopsy. As no pericardial biopsy was performed, we should have asked a thoracic/cardiac surgeon to conduct a biopsy during the debridement operation. If the tumor had been localized to the pericardium, it could have been removed.

Conclusion: It is necessary to consider the best method for performing the most thorough histological examination possible, even in areas where histological examinations are difficult, as all ulcers can contain tumors.
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http://dx.doi.org/10.1016/j.ijscr.2020.05.081DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317167PMC
June 2020

Acquired agminated melanocytic nevus in the acral area is a potential mimicker of acral lentiginous melanoma: A three-case series report and published work review.

J Dermatol 2020 Jul 4;47(7):770-773. Epub 2020 May 4.

Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan.

Agminated nevus refers to a clustered group of melanocytic nevi confined to a localized area of the body. It rarely involves acral skin, but recognition of acquired agminated nevus (AAN) in the acral area is clinically important because it may mimic acral lentiginous melanoma (ALM). However, acral AAN has only been described in a few case reports and its clinical characteristics remain unclear. We report three additional cases of acral AAN to further analyze the differential points between ALM. Clinical images, including those of dermoscopy, of three cases of acral AAN were reviewed. The lesions were located on the sole or lateral border of the foot. All acral AAN were flat and large in size (>20 mm in greatest dimension), and associated with asymmetry and irregular border. However, no parallel ridge pattern suggesting ALM was observed on dermoscopy. In two patients, the lesions on the sole were totally resected; microscopic evaluation of these two lesions confirmed junctional nests of banal melanocytes. AAN lesions on the sole with chronic mechanical pressure are slightly larger and more diffuse; thus, they may be more likely to be overdiagnosed as malignancy upon inspection than those in the non-acral area. Understanding the concept of the disease and careful dermoscopic evaluation leads to an accurate diagnosis.
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http://dx.doi.org/10.1111/1346-8138.15353DOI Listing
July 2020

Adult-onset Asymmetrical Lipomatosis.

Acta Derm Venereol 2020 Mar 12;100(6):adv00080. Epub 2020 Mar 12.

Department of Dermatology, Nara Medical University Hospital, 840 Shijo, Kashihara, Nara 634-8522, Japan.

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http://dx.doi.org/10.2340/00015555-3439DOI Listing
March 2020

Function Preservation of the Upper Lip after Tumor Resection Using Residual Orbicularis Oris Muscle and Attached Levator Labii Superioris Alaeque Nasi.

Plast Reconstr Surg Glob Open 2018 Oct 4;6(10):e1962. Epub 2018 Oct 4.

Division of Plastic Surgery, Nara Medical University Hospital, Nara, Japan.

We report a case, function preservation of the upper lip after tumor resection was possible using residual orbicularis oris muscle and attached levator labii superioris alaeque nasi. Patient was 67-year-old male with squamous cell carcinoma at the vermilion border. The tumor was resected with an 8-mm margin, leaving the oral mucosa as intact as possible. To reconstruct the red lip, we used the oral mucosa as a rotational transposition flap. The white lip was reconstructed with a cheek rotation flap. A levator labii superioris alaque nasi muscle flap, which was attached to the remaining orbicularis oris muscle, was used to increase marginal lip volume. The movement of the reconstructed lip was good. At 9 postoperative months, induration of the red lip was palpable, and we suspected that the blood supply to the levator labii superioris alaque nasi was borderline insufficient. Slight drooping of the reconstructed lip occurred. We dissected this was caused by dissection of mid facial muscles from orbicularis oris muscle to ease downward rotation of the cheek flap and obscure the original nasolabial fold. Although some drooping and induration of the lip occurred, the white and red lip were reconstructed in a single-stage procedure, which resulted in good movement and preserved the function of the orbicularis oris muscle.
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http://dx.doi.org/10.1097/GOX.0000000000001962DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250460PMC
October 2018

Reconstruction of Near-Total Loss of the Upper and Lower Lips due to Purpura Fulminans with Local Tissue and a Dual-Skin Paddled Anterolateral Thigh Flap.

Plast Reconstr Surg Glob Open 2017 Sep 22;5(9):e1505. Epub 2017 Sep 22.

Division of Plastic Surgery, Nara Medical University Hospital, Nara, Japan.

It is difficult to totally reconstruct the lip, achieving good functional and aesthetic results. There have been few reports of reconstructing complete lip defects. Moreover, upper and lower lip necrosis by purpura fulminans has not been reported. We present a case of a 60-year-old male purpura fulminans patient with upper and lower lip necrosis. Fortunately, our patient had retained his oral commissure function. We reconstructed this defect with an orbicularis oris muscle-skin-mucosal pedicled flap derived from the region between the nasolabial folds for upper lip; a similar bipedicled flap for the lower lip and the donor site was closed with a dual-skin paddled anterolateral thigh flap. Postoperative results were satisfactory, that is, no lip tightness or aperture restriction was seen, and symmetry had been achieved. The new lips exhibited complete sensory recovery. Drooling was minimal during rest and feeding. We could select a method that combined the advantages of local and free flaps. We consider our method for this defect is superior to those described in previous studies, in that the restoration of lip sensation and oral sphincter function can be achieved to some extent in 1 stage while preserving the oral commissure function.
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http://dx.doi.org/10.1097/GOX.0000000000001505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640375PMC
September 2017

A case of abdominoplasty after removal of giant ovarian cyst.

Plast Reconstr Surg Glob Open 2014 Aug 8;2(8):e195. Epub 2014 Sep 8.

Center for Plastic Surgery, Nara Medical University Hospital, Kashihara, Nara, Japan.

Summary: When treating a giant ovarian cyst, management of inferior vena cava (IVC) syndrome, bleeding, abdominal competence, and cosmetic appearance are difficult. The details of abdominoplasty for patients with such a cyst have not been discussed. We present a patient requiring 85,000 ml of fluid evacuation before surgery.
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http://dx.doi.org/10.1097/GOX.0000000000000150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236356PMC
August 2014

Aesthetic reconstruction of a defect in the skin of the upper lip using a hatchet flap.

J Plast Surg Hand Surg 2012 Apr;46(2):80-4

Division of Plastic Surgery, Nara Medical University, Kasihara, Nara, Japan.

Reconstruction of the upper lip requires symmetrical reconstruction of the free border according to the aesthetic principle. We have reconstructed this area with a hatchet flap, so that the scars match the subunit line as far as possible by rotation and advancement of the flap. We operated on six patients. The lower pedicled flap was used in 4 cases and the upper pedicled flap in 2, who also needed reconstruction of the vermillion. In one patient the scar did not match the nasolabial fold. For the upper pedicled cases, scars made on the vermillion were not conspicuous. However, trap door deformity occurred in half, which was a disadvantage. We think that our flap is useful, because it leaves a minimal scar in an inconspicuous area.
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http://dx.doi.org/10.3109/2000656X.2012.669193DOI Listing
April 2012

Chronic expanding hematoma in the temporal region.

J Craniofac Surg 2006 May;17(3):567-70

Division of Plastic Surgery, Nara Medical University, Nara, Japan.

We report a rare case of chronic expanding hematoma in the right temporal region that developed into a large mass during 12 years. The patient, who had a history of blunt trauma in her right temporal region at the age of 4 months, noticed a slowly growing mass at the same site in the last few months. Computed tomography revealed a well-circumscribed subcutaneous tumor. The tumor was completely resected. Histopathologically, this tumor was confirmed in the diagnosis of chronic expanding hematoma.
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http://dx.doi.org/10.1097/00001665-200605000-00031DOI Listing
May 2006

Perforating pilomatricoma on the upper eyelid.

J Craniofac Surg 2006 Mar;17(2):372-3

Division of Plastic Surgery, Nara Medical University, Kashihara, Japan.

We report a rare case of perforating pilomatricoma. A 50 x 40-mm oval nodule, with a whitish scale on its tip, developed on the left upper eyelid of a 43-year-old Japanese woman. There was no history of injury to the left upper eyelid. Histologic examination revealed typical microscopic features of pilomatricoma. In addition, however, an interesting phenomenon was observed: a portion of the tumor mass had extruded from the upper dermis to the skin surface through a perforating epidermal channel in the middle of the tumor. These findings are consistent with the diagnosis of perforating pilomatricoma.
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http://dx.doi.org/10.1097/00001665-200603000-00031DOI Listing
March 2006

Histological evaluation of grafted hard palate mucosa in the reconstruction of the upper eyelid.

Scand J Plast Reconstr Surg Hand Surg 2005 ;39(6):376-8

Division of Plastic Surgery, Nara Medical University, Kashihara, Nara, Japan.

We have used a hard palate mucosal graft for reconstruction of the posterior lamella of the eyelid and in only one case was replacement required because of discomfort and pain. The stratum corneum of the hard palate mucosa may have been the cause.
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http://dx.doi.org/10.1080/0284431051006358DOI Listing
February 2006

Lymphoma of mucosa-associated lymphoid tissue (MALT) arising in the parotid gland.

J Craniofac Surg 2005 Jul;16(4):693-6

Department of Dermatology, Division of Plastic Surgery, Nara Prefectural Nara Hospital, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan.

Malignant lymphoma of the parotid gland is a rare condition. The authors present the case of a 59-year-old woman with primary malignant lymphoma arising from the parotid gland, in which they resected the tumors and surrounding lymph nodes. Histopathologic examination of the tumor demonstrated a lymphoma of mucosa-associated lymphoid tissue (MALT). Chemotherapy and radiotherapy were performed after surgery. The clinical manifestation, treatment, and postoperative course are described.
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http://dx.doi.org/10.1097/01.scs.0000147390.06617.2eDOI Listing
July 2005

Mortality and recurrence rate after pressure ulcer operation for elderly long-term bedridden patients.

Ann Plast Surg 2005 Jun;54(6):629-32

Department of Plastic Surgery, Hikone Central Hospital, Shiga Prefecture, Hikone-Shi Nishiima-chou, Japan.

We operated on 16 sacral pressure ulcers in elderly and long-term residential patients who were immobile as a result of cerebral vascular disease. The mean age of patients was 76 years. Eight ulcers were treated with local fascial flaps and 8 by simple closure. The follow-up period was from 1 to 4 years. Recurrence and mortality rates were examined retrospectively. In the 16 patients, recurrence occurred in 37.5%, and 43.8% died without recurrence. The recurrence rate was 37.5% for local fascial flaps and 37.5% for simple closure. Overall mortality was 68.8% in the follow-up period. Because postoperative death was common, we should not only focus on reducing local pressure but also pay attention to any underlying disease. Because of this high mortality rate, the least invasive procedure possible should be used. Because the recurrence rate of simple closure was the same as for local fascial flaps, simple closure should be considered as a reconstructive method.
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http://dx.doi.org/10.1097/01.sap.0000164465.40841.0bDOI Listing
June 2005

The use of calcium phosphate cement paste for the correction of the depressed nose deformity.

J Craniofac Surg 2005 Mar;16(2):327-31; discussion 331

Hatoko Plastic Surgery Clinic, Karutabon Building 2nd Floor, 61 Kawaraguchi, Kashiba City, Nara 639-0225, Japan.

The authors report the use of calcium phosphate cement paste as a material for correction of depression after nasal bone fracture, and evaluate its usefulness. Biopex R (Mitsubishi Material Corporation, Tokyo, Japan) was used in this study as calcium phosphate cement (CPC), which was developed in Japan. CPC injection was used in six patients (four women and two men) with depressed nose deformity after nasal bone fracture. The patients' ages ranged from 29 to 67 years (mean, 49 years), and the follow-up period ranged from 12 to 27 months. The amount of injected cement varied from 0.5 to 2.5 mL, approximately. There was no postoperative infection or allergic reaction in any patient. Clinical and X-ray photography findings showed that a reduction in volume of the injected cement occurred gradually as long as 7 to 8 months after surgery. After that period, the volume was mostly maintained. It seemed that the degree of reduction was approximately 10% to 15% of the original volume. Satisfactory results were obtained in all cases. The authors conclude that the use of CPC is an option for the correction of depressed nose deformity and that its application must be determined in each case, considering its advantages and disadvantages.
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http://dx.doi.org/10.1097/00001665-200503000-00024DOI Listing
March 2005

Chronic expanding hematoma in the temporal region.

J Craniofac Surg 2005 Jan;16(1):158-61

Division of Plastic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

A rare case of chronic expanding hematoma in the right temporal region that developed into a large mass over the course of 12 years is reported. The patient, who had a history of blunt trauma to her right temporal region at the age of 4 months, noticed a slowly growing mass at the same site over the last few months. Computed tomography revealed a well-circumscribed subcutaneous tumor. The tumor was completely resected. Histopathologically, the diagnosis of chronic expanding hematoma was confirmed.
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http://dx.doi.org/10.1097/00001665-200501000-00032DOI Listing
January 2005

Adult umbilical hernia with vertical dislocation.

Scand J Plast Reconstr Surg Hand Surg 2004 ;38(1):58-61

Division of Plastic Surgery, Nara Medical University, Kashihara, Japan.

We present a case of adult umbilical hernia with vertical dislocation along the abdominal wall. The hernial sac arose from the internal ring and connected to the umbilicus 20 mm below the internal ring. The postoperative course was uneventful. Two years and four months after the operation there was no evidence of recurrent hernia even when abdominal pressure was increased, and the umbilicus looked acceptable. An umbilical hernia is usually within the umbilicus. The hernial sac arose from the internal ring so should be called an umbilical hernia not an epigastric hernia. It is unusual that the umbilical hernia dislocates vertically along the abdominal wall, while the umbilicus stays depressed. This atypical form of umbilical hernia has not been described previously as far as we know.
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http://dx.doi.org/10.1080/02844310310013037DOI Listing
July 2004

Hard-palate mucosal graft in the management of severe pincer-nail deformity.

Plast Reconstr Surg 2003 Sep;112(3):835-9

Division of Plastic Surgery, Nara Medical University, Kashihara City, Japan.

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http://dx.doi.org/10.1097/01.PRS.0000070178.32975.9EDOI Listing
September 2003

Expression of alpha, beta, and gamma catenins in vascularized and nonvascularized nerve grafts during the regeneration process.

J Reconstr Microsurg 2003 May;19(4):271-8

Division of Plastic Surgery, Nara Medical University, Kashihara, Japan.

The authors investigated the expression of three kinds of catenins (alpha, beta, gamma) in vascularized and non-vascularized nerve grafts, using the rat sciatic nerve model. The vascularized nerve, 15 mm in length, was elevated with its nutrient vessels in the left hindlimb of rats. In the right hindlimb, a 15-mm segment of the sciatic nerve was elevated (resected) without the nutrient vessels as a non-vascularized nerve. Both nerves were sutured to the original site. At various periods up to 14 weeks after operation, the entire graft was removed. Expression of three catenins was detected by Western blot analysis and histochemical staining, using the antibody to each catenin. The level of beta catenin increased during nerve regeneration in both the vascularized and non-vascularized grafts, while the level of alpha and gamma catenins did not increase in both grafts. There was no difference in the level of the three catenins between the two methods of nerve grafting. Histochemical findings showed that at the 4th and 14th postoperative weeks, alpha and gamma catenins were stained diffusely in both grafts, while beta catenin was stained around the regenerating axons in both grafts. The degree of beta catenin was greater in the 4th postoperative week than in the 14th postoperative week, but no obvious difference in the degree of staining of the three catenins between two grafts was found. These results suggest that beta catenin may play a different role from alpha and gamma catenins in nerve regeneration, and that the expression of these catenins is not influenced by vascularization of the nerve graft.
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http://dx.doi.org/10.1055/s-2003-40584DOI Listing
May 2003

Distortion and movement of the expander during skin expansion.

Scand J Plast Reconstr Surg Hand Surg 2003 ;37(1):22-7

Division of Plastic Surgery, Nara Medical University, Kashihara, Nara, Japan.

Distortion and movement of tissue expanders can cause expansion of the wrong area, such as the naevus or the scar that is to be resected. In 71 rectangular expanders, we examined the incidence of distortion (over 15 degrees) and movement (over 3 cm). We divided the expanders into three anatomical site groups: scalp, body, and extremities, and compared the complication rate between two study groups (distortion or movement, or not). In total, the incidence of distortion was 15/71 (21%) and that of movement 5/71 (7%). Distortion occurred mainly in the extremities (11/33,33%). The implanted expanders tended to move more often in the body part (3/15, 20%). In the extremities, the bigger the angle between the axis of the implanted expander and that of the extremity, the bigger the angle of distortion. Although the incidence of complications between the two groups was not significant, except for alteration in design of the flap, we recommend that these points should be considered when preoperative plans are being made for appropriate patients.
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http://dx.doi.org/10.1080/alp.37.1.22.27DOI Listing
May 2003

Influence of periosteum on donor healing after harvesting hard palate mucosa.

Ann Plast Surg 2003 Jan;50(1):25-30

Division of Plastic Surgery, Nara Medical University, Kashihara, Japan.

The authors report the influence of periosteum on healing of palatal defect based on more than 10 years of experience of harvesting hard palate mucosa. Between June of 1991 and May of 2001, the authors harvested 80 hard palate mucosae as graft material for skin and mucosa defects. All grafts were harvested from the center of the hard palate. Patients ranged in age from 10 to 82 years old. Of 80 mucosae, 54 were harvested with periosteum, and periosteum was not retained in the defect bed. The other 26 mucosae were harvested without periosteum, which was therefore retained in the defect bed. The healing time increased depending on the defect size in both groups of patients retaining and not retaining periosteum. There was a significant relationship between the defect size and healing time in both groups (Spearman's rank correlation test, p < 0.0001 in both groups). In the two groups, there was no significant relationship between patient age and healing time in the patients with defect smaller than 1.99 cm or larger than 2.00 cm2. There were no significant differences in the rate of patients with pain and bleeding between the groups retaining and not retaining periosteum. In the group not retaining the periosteum, all 54 patients showed a flat or atrophic smooth surface at more than 6 months after epithelization and had no discomfort. However, 17 patients showed flat or atrophic smooth surface in the group retaining the periosteum and the remaining 9 patients showed hypertrophy at more than 6 months after epithelization, with accompanying discomfort. The rate of the patients with hypertrophy in the group of patients retaining periosteum was significantly high as compared with that in the group of patients not retaining periosteum (p = 0.000013, Fisher's exact test). In 26 patients retaining periosteum, the age of the patients with hypertrophic surface was significantly younger than that of the patients with flat or atrophic surface (p = 0.0010, Welch's -test), and the defect size in the patient with hypertrophic surface was significantly smaller than that of the patients with flat or atrophic surface (p = 0.0028, Welch's t-test). In conclusion, our study demonstrated that the existence of periosteum in the palate donor bed does not contribute to reduced healing time or reduced pain. Rather, retaining the periosteum caused hypertrophy of the donor site, leading to discomfort, especially in young patients with a comparatively small defect.
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http://dx.doi.org/10.1097/00000637-200301000-00005DOI Listing
January 2003

Usefulness and limitations of artificial dermis implantation for posttraumatic deformity.

Aesthetic Plast Surg 2002 Sep-Oct;26(5):360-4

We have previously reported the use of artificial dermis implantation to cover exposed major vessels and to correct a depressed region after tissue resection and bone deformity with satisfactory results. In this paper, we present cases with depressed lesions and adhesive lesions after trauma, treated with artificial dermis implantation. Artificial dermis (Terudermis, Terumo Co. Ltd., Tokyo, Japan) was implanted in 12 cases of posttraumatic deformity. Eight of the 12 cases involved a depressed lesion, and the other four involved adhesive lesions. There was no postoperative infection or allergic reaction in any of the patients. Improvement of the deformity was obtained in all cases, but the degree of volume reduction in traumatic cases is likely to be more severe than that in the non-traumatic cases previously reported. In conclusion, artificial dermis implantation is an easy, safe, and useful method to correct a posttraumatic deformity, such as a depression or an adhesion, although it is important to note that depressions require overcorrection in order to obtain satisfactory results, as compared with non-traumatic cases treated with artificial dermis.
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http://dx.doi.org/10.1007/s00266-002-2048-0DOI Listing
February 2003

Hard palate mucosal grafts for defects of the nail bed.

Ann Plast Surg 2002 Oct;49(4):424-8; discussion 428-9

Division of Plastic Surgery, Nara Medical University, 840 Shijocho, Kashihara, 634-0813 Japan.

The authors present 2 children in whom a hard palate mucosal graft was used for a defect of the nail bed after resecting subungual exostosis. After the tumor was resected with the overriding nail bed, hard palate mucosa without periosteum was grafted to the nail bed defect. In both patients the graft took completely, and within 2 weeks after the operation the patients were able to enjoy activities of daily life, including athletic movement, without any symptoms. Nail growth was uneventful and was complete in 4 or 5 months after the operation without any complications. The authors think that a hard palate mucosal graft is a valid choice for a defect of the nail bed, and the mucosa does not need to be harvested with periosteum. The grafting of hard palate mucosa without periosteum to a defect of the nail bed contributes to a shorter healing time, resulting in a reduction in the period of restriction of movement in activities of daily life, and this is a great advantage in children.
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http://dx.doi.org/10.1097/00000637-200210000-00016DOI Listing
October 2002

Evaluation of scars after harvest of the temporoparietal fascial flap depending on the design of the skin incision.

Ann Plast Surg 2002 Apr;48(4):376-80

Division of Plastic Surgery, Nara Medical University, Kashihara, Japan.

The authors evaluated the conspicuousness of the temporal scar caused by two incision patterns after harvesting the temporoparietal fascial flap: a straight incision and a zigzag incision. The 27 scars of 27 patients were examined in this study. Fifteen patients underwent a straight incision and 12 patients had a zigzag incision. This study showed that the zigzag incision resulted in more conspicuous scars than the straight incision and that this effect was more evident in younger patients than in older patients, at least in Japanese. In a comparison of older patients and younger patients irrespective of the skin incision patterns, the scars were substantially more conspicuous in the younger patients. A simple and short incision is preferred when harvesting the temporoparietal fascial flap and more careful management is required for young patients.
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http://dx.doi.org/10.1097/00000637-200204000-00007DOI Listing
April 2002

Penile reconstruction for extramammary Paget's disease.

Ann Plast Surg 2002 Jun;48(6):672-5

Division of Plastic Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-0813, Japan.

The authors report their experience of an extremely rare case of extramammary Paget's disease presenting a deformational change of the penis, which required penile reconstruction after tumor resection. Tumor cells had invaded the dermis beyond the basement membrane of the epidermis. Tumor cells were found at the epithelium of the urethra, but had not invaded the corpus cavernosum. However, fibrotic changes were found in the corpus cavernosum. More than half the length of the penis was resected. Penile reconstruction was performed using a free sensory radial forearm flap. The defects in the mons pubis, scrotum, and the remaining corpus cavernosum were covered using a meshed split skin graft or sheeted split skin graft. Ten months after the operation, the tumor had not recurred and no metastasis was found. The urinary stream was narrow compared with that of a healthy man, but urinary voiding had not been disturbed. Sensory recovery was 12 mm with the two-point discrimination test at the distal end of the reconstructed penis.
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http://dx.doi.org/10.1097/00000637-200206000-00019DOI Listing
June 2002

Preshaped hydroxyapatite tricalcium-phosphate implant using three-dimensional computed tomography in the reconstruction of bone deformities of craniomaxillofacial region.

J Craniofac Surg 2002 Mar;13(2):287-92

Division of Plastic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan.

We prepared solid life-sized models and templates of implants based on three-dimensional computed tomography data in six cases with a bone deformity of the craniomaxillofacial region. After simulation surgery using these models and templates, the preshaped hydroxyapatite-tricalcium phosphate (HAP-TCP) implants were prepared to fill in the facial bone defects, and implantation was performed. Consequently, implants fitted the individual bone defects, and satisfactory facial contouring was obtained in five cases. In one case with severe cutaneous scarring in the grafted site, it was necessary to reduce the volume of the preshaped HAP-TCP implant during surgery. In conclusion, the three-dimensional, solid, life-sized model and template are useful for preoperative detailed simulation, and the use of preshaped HAP-TCP implants based on the template probably contributes to successful reconstruction of complex facial bone deformities and to the reduction of surgical invasion, resulting in achievement of better results.
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http://dx.doi.org/10.1097/00001665-200203000-00018DOI Listing
March 2002

Rare case of a rudimentary medial metatarsal non-ossified structure.

Scand J Plast Reconstr Surg Hand Surg 2002 ;36(1):60-3

Division of Plastic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-0813, Japan.

A 9-year-old boy presented with a rudimentary medical metatarsal non-ossified structure. We considered his condition to be classified as hypoplastic medial member type in the metatarsal type of medial ray polydactyly. When it was considered as polydactyly, it had the longest delay of ossification among reported cases.
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http://dx.doi.org/10.1080/028443102753478417DOI Listing
September 2002

Correction of bone deformity after resection of dermoid cyst using artificial dermis implantation.

Aesthetic Plast Surg 2002 Jan-Feb;26(1):35-9

Division of Plastic Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-0813 Japan.

We report cases of the dermoid cyst patients with a bone deformity that were treated with artificial dermis implantation. After resecting the tumor, three or five sheets of artificial dermis (Terudermis, Terumo Co. Ltd, Tokyo, Japan) are placed into the depressed site in order to create symmetrical surface with the contralateral side. Neither of the cases presented here showed allergic or infectious reaction during postoperative follow-up period. In both cases, the texture of the implanted region is almost the same as the contralateral side and is almost symmetrical. We believe that artificial dermis may be a useful implantation material to correct depressions in the patient with dermoid cysts.
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http://dx.doi.org/10.1007/s00266-001-0005-yDOI Listing
April 2002

Difference of molecular response to ischemia-reperfusion of rat skeletal muscle as a function of ischemic time: study of the expression of p53, p21(WAF-1), Bax protein, and apoptosis.

Ann Plast Surg 2002 Jan;48(1):68-74

Division of Plastic Surgery, Nara Medical University, 840 Shijocho, Kashihara, 634-0813, Japan.

The authors investigated the expression of p53, p21(WAF-1), Bax protein, and apoptosis to elucidate the cellular response to ischemia-reperfusion of skeletal muscle using the rat lower limb model. The rat left lower limb was dissected in the inguinal region, isolating the bony femoral muscles, and the femoral vessels were clamped to produce an ischemic condition. After 3 or 6 hours, the clamps were removed and the gastrocnemius muscle was resected at various times up to 72 hours after reperfusion. Five specimens of the muscle were obtained at each time point from 5 rats. When any rat died during the study, additional rats were used until 5 specimens could be obtained from 5 rats at each time point. The expression of three proteins was detected by Western blot analysis. The apoptotic cells were detected using terminal deoxytransferase-mediated dUDP (deoxyuridine[-5']diphosphate) nick-end labeling assay. Histopathological study showed severe interstitial edema and leukocyte infiltration at 6 hours of ischemia compared with 3 hours of ischemia. Moreover, at 6 hours of ischemia, muscle fiber fragmentation was observed at 72 hours after reperfusion whereas no fragmentation was found at 3 hours of ischemia. At 3 hours of ischemia, p53 and p21(WAF-1) accumulated after reperfusion, and there was a time lag in the time of onset of elevation and the peak time point between these two proteins. The level of Bax protein did not elevate and the rate of apoptotic cells did not increase. At 6 hours of ischemia, p53 and p21(WAF-1) also accumulated, but the kinetics of p21(WAF-1) were similar to that of p53 in the time of onset of elevation and the peak time point after reperfusion. In addition, the level of Bax protein increased and apoptosis was induced. These results demonstrated that p53 and p21(WAF-1) accumulated after 3 and 6 hours of ischemia of skeletal muscle during reperfusion. Moreover, it was demonstrated that the kinetics of induced p53, p21(WAF-1) and Bax protein differ between 3 hours and 6 hours of ischemia, and it is speculated that this difference plays an important role in determining the consequence of the cell exposed to ischemia.
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http://dx.doi.org/10.1097/00000637-200201000-00010DOI Listing
January 2002