論文 - 貴志　和生

Evaluation of bone volume after secondary bone grafting in unilateral alveolar cleft using computer-aided engineering

Nagashima Hayato, Sakamoto Yoshiaki, Ogata Hisao, Miyamoto Junpei, Yazawa Masaki, Kishi Kazuo

Cleft Palate-Craniofacial Journal 51 （ 6 ） 665 - 668 2014年11月

ISSN  1055-6656

　概要を見る

<p>The purpose of this study was to evaluate the initial defect and the outcome of bone grafts for unilateral alveolar cleft. To determine the absorption of the bone graft in patients with unilateral cleft, computer-aided engineering (CAE) with multi-detector row computed tomography (MDCT) was used. MDCT scans of 29 patients were taken immediately preoperatively and at 1 month and 6 months postoperatively. The patients underwent bone grafting between 8 and 14 years of age using iliac crest bone grafts. Three-dimensional models were created in each period, and the defect at the alveolar cleft and volume of the bone graft were determined in each patient using CAE. Cleft volume and success of alveolar bone grafting were significantly correlated (P &lt; .01). Alveolar clefts with cleft palate required more bone volume than those without cleft palate (P &lt; .01), but the resorption rate did not significantly differ between alveolar clefts with and without cleft palate (0.48 ± 0.14 and 0.49 ± 0.18, respectively; P = .93). In conclusion, three-dimensional reconstruction of bone grafts using CAE based on MDCT provides a valuable objective assessment of graft volume.</p>

• Access to Document (DOI)

A titanium screw-retaining temporary denture on the raw surface muscular flap for the immediate maxillary reconstruction

Miyashita Hidetaka, Asoda Seiji, Horie Nobuyuki, Usuda Shin, Kato Shin, Muraoka Wataru, Yamada Yuka, Yoshikawa Momoko, Hasegawa Toshihiro, Onizawa Katsuhiro, Tanaka Ichiro, Yazawa Masaki, Ogata Hisao, Kishi Kazuo, Tomita Toshiki, Nakagawa Taneaki, Kawana Hiromasa

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2014年10月

ISSN  2212-5558

　概要を見る

<p>Objective: In any immediate reconstruction of the maxillofacial defect after total maxillectomy, the defect is often covered with a flap, however, dentures cannot be maintained stably by the flap, because of the high mobility and large amount of displacement of the flap under pressure. Therefore, we developed a method in which a muscle flap is transplanted without creating a skin island in the oral cavity and a denture is immediately fixed with titanium screws, and obtained favorable results. Patients and methods: The subjects were 9 patients who underwent resection for maxillary sinus cancer. In all patients, a free rectus abdominis muscle flap was used for the reconstruction and the raw surface of the muscle tissue was left in the oral cavity without creating a skin island. Dentures that had been made preoperatively were fixed on the remaining palate and alveolus with titanium screws for one month, so that they covered the muscle tissue. Results: Good palatal morphology was formed without hanging down after epithelialization of the surface of the muscle tissue. In comparison with the preoperative levels, the masticatory and conversational functions recovered to 77% and 90%, on average. Conclusions: Our method is considered to be one of the useful reconstruction methods for maxillofacial defects.</p>

• Access to Document (DOI)

Inferolateral marginal orbitectomy

Shimizu Y., Nagasao T., Sakamoto Y., Kishi K.

International Journal of Oral and Maxillofacial Surgery 43 （ 10 ） 1211 - 1215 2014年10月

ISSN  0901-5027

　概要を見る

<p>The number of patients with mild exophthalmos, without severe eye symptoms, who wish to undergo aesthetic orbital decompression, is increasing. Removal of the lateral and inferior orbital walls is a common procedure for mild to moderate exophthalmos. However, the limited space between the globe and the orbital wall is often troublesome for surgeons introducing surgical devices. As a result, the decompression tends to be insufficient in the posterior region of the orbit. We describe a simple adjuvant surgical technique to address this limitation. Through a laterally extended, transconjunctival approach, the inferior and lateral margins of the orbit are removed in a crescent shape before the actual decompression. This manoeuvre widens the working space and offers better visibility, enabling sufficient removal of the orbital walls. The technique presented facilitates the approach to the posterior regions of the orbit, enabling surgeons to more easily perform orbital decompression.</p>

• Access to Document (DOI)

Surgical treatment for medically refractory myasthenic blepharoptosis

Shimizu Yusuke, Suzuki Shigeaki, Nagasao Tomohisa, Ogata Hisao, Yazawa Masaki, Suzuki Norihiro, Kishi Kazuo

Clinical Ophthalmology 8   1859 - 1867 2014年09月

ISSN  1177-5467

　概要を見る

<p>Patients and methods: Eight patients who failed to respond to at least 2 years of medical treatment and who underwent blepharoptosis surgery, from January 2008 to December 2011, were enrolled in this study. Medical records, photographs, and questionnaire results regarding postoperative status were evaluated. Of the eleven procedures performed, four involved frontal suspension, four involved external levator advancement, one involved nonincisional transconjunctival levator advancement, and two involved subbrow blepharoplasty with orbicularis oculi muscle tucking. The margin reflex distance improved postoperatively in seven patients.</p><p>Purpose: Currently, only a few reports have recommended surgery as a suitable treatment for blepharoptosis associated with myasthenia gravis. The present study aims to introduce our surgical criteria, surgical options, outcomes, and precautions for medically refractory myasthenic blepharoptosis.</p><p>Results: Seven patients had very minimal scarring, and one had minimal scarring. Five patients showed no eyelid asymmetry, one had subtle asymmetry, and two had obvious asymmetry. Seven patients were very satisfied, and one patient was satisfied with the overall result. Postoperative complications included mild lid lag with incomplete eyelid closure, prolonged scar redness, and worsened heterophoria. No patient experienced postoperative exposure keratitis or recurrent blepharoptosis during the study period.</p><p>Conclusion: Our results indicate that blepharoptosis surgery is effective for patients with myasthenia gravis, especially those with residual blepharoptosis despite multiple sessions of medical treatments. We recommend that neurologists and surgeons collaborate more systematically and discuss comprehensive treatment plans to increase the quality of life for patients with myasthenia gravis.</p>

• Access to Document (DOI)

Evaluation of Antibiotic-loaded Calcium Phosphate Bone Cement in a Cranium-infected Experimental Model

貴志 和生

NEUROLOGIA MEDICO-CHIRURGICA 54 （ 8 ） 647 - 653 2014年08月

研究論文（学術雑誌）,  ISSN  0470-8105

• Access to Document (DOI)

Concentration of rat bone marrow nucleated cells using hypo-osmotic hemolysis in distilled water

Ohnishi Fumio, Ochiai Hiroko, Kishi Kazuo

Plastic and Reconstructive Surgery 2014年07月

ISSN  0032-1052

　概要を見る

<p>BACKGROUND: Bone marrow aspirates contain primarily red blood cells. To achieve efficient cell transplantation for regeneration, the red blood cells need to be removed from the aspirates. Cell isolation is typically performed using density gradient centrifugation. However, this method entails issues of clinical safety and convenience. This study describes an efficient method to concentrate bone marrow nucleated cells by hypo-osmotic hemolysis. METHODS: The optimal hemolysis conditions were determined by diluting the bone marrow suspensions with distilled water in various dilution ratios. Then, the resulting cell fractions were transplanted in a rat cranial defect model to evaluate their effects on bone formation and their angiogenic effects. RESULTS: The optimal hemolysis conditions were a 3.3-fold dilution in distilled water and a hypo-osmotic exposure time of 45 seconds. Nucleated cells obtained using this method included granulocytes and mononuclear cells. These cells contain cytoplasmic angiogenic factors, including vascular endothelial growth factor, basic fibroblast growth factor, and hepatocyte growth factor. In a rat cranial defect model, callus formation and angiogenesis were significantly increased following transplantation of concentrated marrow nucleated cells in this manner. CONCLUSIONS: These results suggest angiogenic and osteogenetic effects of transplanting marrow nucleated cells using this hypo-osmotic method.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0. American Society of Plastic Surgeons.</p>

• Access to Document (DOI)

3-D analysis of dislocation in zygoma fractures

貴志 和生

JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY 42 （ 5 ） 397 - 402 2014年07月

研究論文（学術雑誌）,  ISSN  1010-5182

• Access to Document (DOI)

Phlebectasia of the external jugular vein with thrombosis: report of a case

貴志 和生

SURGERY TODAY 44 （ 6 ） 1180 - 1183 2014年06月

研究論文（学術雑誌）,  ISSN  0941-1291

• Access to Document (DOI)

Relationship between Locations of Rib Defects and Loss of Respiratory Function-A Biomechanical Study

貴志 和生

THORACIC AND CARDIOVASCULAR SURGEON 62 （ 4 ） 357 - 362 2014年06月

研究論文（学術雑誌）,  ISSN  0171-6425

• Access to Document (DOI)

Original article classification of congenital midline upper lip sinuses

Aoki Marie, Sakamoto Yoshiaki, Nagasao Tomohisa, Miyamoto Junpei, Kishi Kazuo

Cleft Palate-Craniofacial Journal 51 （ 2 ） 154 - 157 2014年03月

ISSN  1055-6656

　概要を見る

<p>Background: We recently encountered a case of a midline upper lip sinus, one of the rarest congenital lip sinuses. Several embryological hypotheses have been proposed regarding the etiology of this rare disease, but it remains obscure. Methods: We reviewed all cases of upper lip sinus reported in the English language through 2011, and classified them into three types according to accompanying anomalies and the site of the fistula. Results: Twenty-eight studies involving 31 cases were reviewed and classified. A type I sinus was a midline sinus without accompanying anomalies. There were 13 such cases, with a female predilection. Type II sinuses were midline sinuses with accompanying anomalies, and there were nine such cases. Type III sinuses were lateral sinuses with or without accompanying anomalies; there were nine cases. Conclusions: Our classification scheme is not only convenient for clinical application, but also reflects the embryological process responsible for congenital lip sinuses.</p>

• Access to Document (DOI)

Spatial and temporal control of laminin-332 and-511 expressions during hair morphogenesis

貴志 和生

MEDICAL MOLECULAR MORPHOLOGY 47 （ 1 ） 38 - 42 2014年03月

研究論文（学術雑誌）,  ISSN  1860-1480

• Access to Document (DOI)

Combined use of resorbable poly-l-lactic acid-polyglycolic acid implant and bone cement for treating large orbital floor fractures

Sakamoto Yoshiaki, Shimizu Yusuke, Nagasao Tomohisa, Kishi Kazuo

Journal of Plastic, Reconstructive and Aesthetic Surgery 67 （ 3 ）  2014年03月

ISSN  1748-6815

• Access to Document (DOI)

The "halo technique"

Sakamoto Yoshiaki, Nakajima Hideo, Kishi Kazuo

International Journal of Dermatology 53 （ 2 ）  2014年02月

ISSN  0011-9059

• Access to Document (DOI)

Combined usage of intercostal nerve block and tumescent anaesthesia

Shimizu Yusuke, Nagasao Tomohisa, Taneda Hiroko, Sakamoto Yoshiaki, Asou Toru, Imanishi Nobuyuki, Kishi Kazuo

Journal of Plastic Surgery and Hand Surgery 48 （ 1 ） 51 - 55 2014年02月

ISSN  2000-656X

　概要を見る

<p>Patients are occasionally unhappy with the size, shape, and positioning of breast implants. An option to improve their satisfaction with breast augmentation includes directly involving them in the process with awake surgery done under nerve block and tumescence. This study describes the resultsof using such an awake anaesthesia technique in 35 patients. After the intercostal nerves dominating the Th3 to Th6 regions were anaesthetized using 0.5% bupivacaine, a tumescent solution consisting of lidocaine, epinephrine, and saline was injected around the mammary gland, and breast augmentation was conducted using silicon implants. The majority of patients (31/35) reported no pain during the procedure and all patients were able to choose and confirm their final implant size and positioning. In all cases, blood loss was less than 10 ml. No patient experienced pneumothorax or toxicity of local anaesthetics. Combined usage of the intercostal nerve block and tumescent anaesthesia effectively reduces pain during breast augmentation. Keeping patient conscious enables meeting their requests during operation, contributing to increased satisfaction. For these advantages, combined usage of the intercostal nerve block and tumescent anaesthesia is recommended as a useful anaesthetic technique for breast augmentation.</p>

• Access to Document (DOI)

New pathogenesis and the classification in scaphocephaly

Sakamoto Yoshiaki, Nakajima Hideo, Tamada Ikkei, Miwa Tomoru, Kishi Kazuo, Yoshida Kazunari

Journal of Plastic Surgery and Hand Surgery 48 （ 1 ） 24 - 27 2014年02月

ISSN  2000-656X

　概要を見る

<p>The aetiology of scaphocephaly is often described as premature fusion of the sagittal suture. This study observed wave-like deformations in abnormally long and narrow skulls typical of scaphocephaly, and these deformations were divided into two types: type I deformations (one wave) and type II deformations (two waves). However, the pathogeneses of these deformations are unknown. Computed tomographic data sets were retrospectively analyzed from 18 patients with scaphocephaly who were admitted to the hospital between 2000-2010. Using three-dimensional reconstructions of the computed tomographic images, the relationship was analysed between the wave deformation types and the state of the sutures and fontanelles. The results demonstrate that the type of wave deformation was dependent on the location of the sagittal suture closure. Specifically, the premature closure of the posterior half of the sagittal suture caused a type I deformation, while total closure resulted in a type II deformation (p &lt; 0.001). It is hypothesized that restricted growth of the fused suture causes billowing, which results in a waving deformation. The deformities that are often observed in sagittal synostosis can be explained more accurately.</p>

• Access to Document (DOI)

Spatial and temporal control of laminin-332 and -511 expressions during hair morphogenesis

Imanishi Hisayoshi, Tsuruta Daisuke, Tateishi Chiharu, Sugawara Koji, Kobayashi Hiromi, Ishii Masamitsu, Kishi Kazuo

Medical Molecular Morphology 47 （ 1 ） 38 - 42 2014年

ISSN  1860-1480

　概要を見る

<p>Hair is one of the smallest organs, but has many important functions to mammals. Hair morphogenesis occurs through the reciprocal exchange of epithelial and mesenchymal signals. There are some reports about the expression of laminin-511 and -332 during hair morphogenesis, but are no reports of the chronological expression and function of laminin-511 and its counter regulator laminin-332 during hair morphogenesis. Our results of immunoblotting revealed that laminin-332 proteins were detected at stage 0 and downregulated during stage 1 to stage 2, and then recovered at stage 3. However, laminin α5 expression was constant throughout stages 0-3. According to the results of semi-quantitative RT-PCR, the mRNA expression of all laminin-332 subunits increased gradually from stage 0 to stage 2, while the mRNA expression of all laminin-511 subunits remained constant from stage 0 to stage 3. Our results suggest that the proper expression of laminin-332 and laminin-511 may regulate appropriate hair morphogenesis.</p>

• Access to Document (DOI)

Is Surgical Intervention Safe and Effective in the Treatment of Myasthenic Blepharoptosis? A Multicenter Survey in Japan

貴志 和生

EUROPEAN NEUROLOGY 71 （ 5-6 ） 259 - 261 2014年

研究論文（学術雑誌）,  ISSN  0014-3022

• Access to Document (DOI)

Alternative continuous quilting suture technique for preventing hematoma in axillary osmidrosis

Shimizu Yusuke, Nagasao Tomohisa, Kishi Kazuo, Asou Toru

Dermatologic Surgery 40 （ 9 ） 1058 - 1060 2014年

ISSN  1076-0512

• Access to Document (DOI)

Combined usage of hydroxyapatite and cross-finger flap for fingertip reconstruction

Nagasao Tomohisa, Kurihara Kunihiro, Shimizu Yusuke, Toriumi Masahiro, Sakamoto Yoshiaki, Jiang Hua, Yu Dazhi, Kishi Kazuo

Journal of Plastic Surgery and Hand Surgery 48 （ 3 ） 205 - 208 2014年

ISSN  2000-656X

　概要を見る

<p>Reconstruction for fingertip defects categorized as Type 3 and Type 4 in Allen's classification is challenging, because surgeons need to reconstruct not only the pulp but also great parts of the distal phalangeal bone. This paper introduces an original technique for the reconstruction of defects of these types. The defects of seven fingers (two small fingers and five index fingers) of seven patients (three males and four females; aged 14-44 years) were repaired. After the fingertip is divided in a fish-mouth fashion to expose the stump of the distal phalangeal bone, a curved block of hydroxyapatite is grafted to fill the phalangeal defect and straighten the nail bed. A rectangular flap is raised from the dorsal side of the neighbouring finger in the region between the PIP and DIP joints. Then the fish-mouth region carrying the grafted hydroxyapatite is covered with the rectangular flap to reconstruct the pulp. The rectangular cross-finger flap is separated 3-4 weeks postoperatively. In all seven cases, the flap survived completely. Infection developed in no case. In all cases, aesthetic appearance of the pulp and nail presented improvement, satisfying the patients. Combined usage of hydroxyapatite and a cross-finger flap from the neighbouring finger is an effective method for the reconstruction of type 3 and type 4 defects in Allen's classification.</p>

• Access to Document (DOI)

Cutaneous carcinosarcoma arising from a burn scar

Fujii Takako, Fukuzumi Satoshi, Hayakawa Kazuhito, Ishida Yasuo, Sakamoto Yoshiaki, Kishi Kazuo

Dermatologic Surgery 40 （ 8 ） 916 - 918 2014年

ISSN  1076-0512

• Access to Document (DOI)