Papers - Kishi, Kazuo

Three-dimensional demonstration of the lymphatic system in the lower extremities with multi-detector-row computed tomography

Yamazaki Shun, Suami Hiroo, Imanishi Nobuaki, Aiso Sadakazu, Yamada Minoru, Jinzaki Masahiro, Kuribayashi Sachio, Chang David W., Kishi Kazuo

Clinical Anatomy 26 ( 2 ) 258 - 266 2013

ISSN  0897-3806

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<p>Sentinel lymph node biopsy (SLNB) has had a great impact on the staging and treatment of cancer. The purpose of this study was to study the lymphatic anatomy of the lower extremities by constructing three-dimensional images using multi-detector-row computed tomography (MDCT). To select appropriate contrast media for MDCT lymphatic imaging in a cadaver, we tested four kinds of contrast media by injecting them into fresh swine kidneys. After the suitable contrast medium was selected, 10 lower extremities from 5 fresh cadavers were studied. After injection of the contrast medium, each lower extremity was scanned with high-spatial-resolution MDCT. The zinc oxide mixture was found to be the most appropriate contrast formula for MDCT imaging of cadaver lymphatics in terms of CT value and no extravasation. The high-resolution MDCT imaging revealed two different superficial lymphatic pathways in the legs. One lymphatic pathway accompanying the great saphenous vein had a constant course and was connected to the superficial inguinal lymph nodes. However, another pathway, along the small saphenous vein, was variable. Some of the deep lymphatic vessels bypassed the inguinal lymph nodes. Using a new protocol, we were able to construct three-dimensional images of the lower extremity lymphatics in a cadaver model. MDCT imaging provided novel information about two different superficial lymphatic pathways in the lower extremities. Clin. Anat., 2013.</p>

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A biomechanical study regarding the effect of tissue harvesting from the thorax on its movement during inspiration

Hatano, Asako, Nagasao, Tomohisa, Shimizu, Yusuke, Jin, Hongmei, Kaneko, Tsuyoshi, Cho, Yasunori, Jiang, Hua, Kishi, Kazuo

COMPUTER AIDED SURGERY 18 ( 5-6 ) 118 - 128 2013

Research paper (scientific journal),  ISSN  1092-9088

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Fetal skin possesses the ability to regenerate completely

Kishi Kazuo, Okabe Keisuke, Shimizu Ruka, Kubota Yoshiaki

Keio Journal of Medicine 61 ( 4 ) 101 - 108 2012.12

ISSN  0022-9717

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<p>Until a certain developmental stage, cutaneous wounds in mammalian fetuses heal rapidly without scars with complete regeneration of the skin. In the process of fetal wound healing, infammatory responses, granulation proliferation, and scar formation that are observed in adults are not seen. Numerous studies have reported the causes of fetal scarless cutaneous regeneration, including reduced expression of TGF-β1 and higher levels of hyaluronan in the extracellular matrix, from the viewpoints of molecular biology and cellular biology, but the mechanisms are not completely understood. Although a variety of substances that inhibit scar formation have been investigated, currently it is almost impossible for adult cutaneous wounds to heal completely without scars. Except for a few animal species, perfect regeneration after wounding can occur only during the gestation period. By strictly comparing the stages before and after the transition from the regeneration of skin to scarring, it will be possible to investigate the mechanisms of cutaneous regeneration.</p>

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Wing flap reconstruction for large defects of the lower lip

Uchikawa, Yumiko, Yazawa, Masaki, Takayama, Masayoshi, Kishi, Kazuo

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 65 ( 12 ) 1725 - 1728 2012.12

Research paper (scientific journal),  ISSN  1748-6815

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Transverse rectus abdominis myocutaneous flap combined with vascularized costal cartilages in cranial reconstruction

Sakamoto Yoshiaki, Kishi Kazuo, Ogata Hisao, Nakajima Hideo

Journal of Craniofacial Surgery 23 ( 6 ) 1687 - 1689 2012.11

ISSN  1049-2275

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<p>Exposing the alloplastic materials after skull reconstruction is very difficult because of the risk of infection and the choice of reconstruction procedures. Conventional procedures were divided into two-step or multi-step surgery. To perform one-stage surgery, a transverse rectus abdominis myocutaneous flap combined with vascularized costal cartilages has been used for head reconstruction after exposing the alloplastic materials in two patients. This is the first report using the flap for skull reconstruction. In this article, we describe the usefulness and the disadvantages of the transverse rectus abdominis myocutaneous flap combined with vascularized costal cartilages.</p>

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A convenient retainer for artificial eye sockets

Shimizu Yusuke, Nagasao Tomohisa, Kishi Kazuo

Journal of Plastic, Reconstructive and Aesthetic Surgery 65 ( 11 ) 1598 - 1599 2012.11

ISSN  1748-6815

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New technique for releasing tension to prevent widening of an abdominal scar

Kishi Kazuo, Imanishi Nobuaki, Kobayashi Naoshi, Nakajima Hideo, Nakajima Tatsuo

Journal of Plastic Surgery and Hand Surgery 46 ( 5 ) 364 - 366 2012.10

ISSN  2000-656X

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<p>We developed an easy way to release tension from an abdominal cutaneous suture by plicating the anterior rectus sheath for several centimetres. We used this in two patients and the scars were satisfactory. Plication of the fascia is an easy and effective way of releasing the tension of a cutaneous sutured line.</p>

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Clinical application of stem cells/progenitor cells in plastic surgery

Kishi Kazuo

Japanese Journal of Plastic Surgery 55 ( 10 ) 1055 - 1059 2012.10

ISSN  0021-5228

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<p>Regenerative medicine has been progressing based on stem cell, scaffold, and developmental researches. Among them, stem cells or progenitor cells play key roles in regenerative medicine. In plastic surgery, many types of stem or progenitor cells are in clinical use. Keratinocyte progenitor cells have been clinically used as cultured epidermal cells. Bone marrow mesenchymal stem cells and adipose derived stem cells are beginning to be applied in various lesions. Although they have the potential to give benefits to the applied lesion, their effects may come not from the regenerative ability of stem cells but from cytokine effects. In order to progress regenerative medicine in plastic surgery, we have to investigate the mechanism of the benefits of the stem cells after application to the lesion.</p>

Maxillomandibular tandem osteotomy with distraction osteogenesis for hemifacial microsomia

Ogata Hisao, Sakamoto Yoshiaki, Sakamoto Teruo, Nakajima Hideo, Kishi Kazuo

Journal of Craniofacial Surgery 23 ( 5 ) 1362 - 1363 2012.09

ISSN  1049-2275

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<p>Currently, simultaneous maxillomandibular distraction osteogenesis is a standard procedure for the correction of hemifacial microsomia. Many variations of the procedure have been reported. However, a common problem has been the extended duration of the procedure. In particular, the lengthy intermaxillary fixation period includes a prolonged distraction series that requires the restriction of oral food intake and creates significant stress for the patient, which has a profound effect on patient satisfaction. To avoid this stress, we have developed tandem osteotomy with distraction osteogenesis, termed the TODO procedure. The TODO procedure not only shortens the intermaxillary fixation period and the duration of therapy but also creates the ideal skeletal proportions, with horizontalization of the occlusal plane. The TODO procedure has the added benefit of producing a marked aesthetic improvement. The patient was extremely satisfied by the result and endured minimal stress.</p>

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Involvement of the sphenosquamosal suture for unilateral coronal synostosis

Sakamoto Yoshiaki, Nakajima Hideo, Tamada Ikkei, Miyamoto Junpei, Kishi Kazuo

Journal of Craniofacial Surgery 23 ( 5 ) 1267 - 1269 2012.09

ISSN  1049-2275

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<p>The etiology of the clinical entity commonly known as unilateral coronal synostosis is often described as the unilateral fusion of the coronal ring. However, recent theories have poorly explained the basis of the deformities associated with unilateral coronal synostosis. We retrospectively analyzed computed tomographic data sets from 18 patients who presented with unilateral coronal synostosis and arrived at our hospital between 1985 and 2010. Using three-dimensional reconstructions of the computed tomographic images, analyses of the cranial base and measurements of each cranial bone were performed. As a result, the ipsilateral and contralateral basion-clinoid-pterion angles did not differ significantly (P = 0.49) and were almost identical in each case. However, the ipsilateral basion-partis-petrosae anglewas wider than the corresponding contralateral angle (P &lt; 0.001). In addition, the ipsilateral nasion-clinoid-pterion angle and the sphenoid, zygomatic, and temporal bones on the ipsilateral side were significantly shorter than those on the contralateral side (P &lt; 0.001). Based on a shortening ratio, the sphenoid bone was smaller (42.0% T 10.9%) than the temporal (68.9% ± 7.58%) and zygomatic bones (71.1% ± 8.38%). This difference was significant (P &lt; 0.001). In conclusion, restricted growth potential of the central portion of the ipsilateral sphenoid bone was identified. We propose that the coronal ring, which includes the frontoparietal and frontosphenoidal sutures, and the sphenosquamosal suture are involved in unilateral coronal synostosis. Using our findings and the theory of Delashaw et al, the deformity observed in unilateral coronal synostosis can be explained more adequately and/or completely.</p>

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The dendritic bonding technique

Sakamoto Yoshiaki, Kishi Kazuo

Journal of Surgical Technique and Case Report 4 ( 2 ) 92 - 93 2012.07

ISSN  2006-8808

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<p>We describe a newly designed technique for the quick, easy, and cost-effective fixation of mesh skin grafts in a range of skin conditions and patients. We fixed the skin graft using octyl-2-cyanoacrylate (Dermabond; Ethicon), which was termed «Dendritic bonding». This technique exhibits several advantages over surgical stapling and suturing with absorbable sutures.</p>

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Use of the LigaSure™ vessel sealing system in neurofibroma excision to control postoperative bleeding

Konno Eri, Kishi Kazuo

Journal of Plastic, Reconstructive and Aesthetic Surgery 65 ( 6 ) 814 - 817 2012.06

ISSN  1748-6815

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<p>Background: The resection of neurofibromas in Von Recklinghausen's disease (NF-1) is frequently complicated by potentially life-threatening intraoperative and postoperative hemorrhage, due to the high tumor vascularity and tissue friability. Methods: This report describes a novel technique for the resection of neurofibromas using the LigaSure™ (Valleylab, Tyco International Healthcare, Boulder, CO) vessel sealing system. We compared five cases of NF-1 tumor removal which used this vessel sealing system, with six cases that did not, and recorded the intraoperative and postoperative blood loss, length of hospitalization, and postoperative complications. Results: In all cases employing the LigaSure™, the perioperative blood loss was less than 600 ml (30 ∼ 570 ml), and no patient developed a postoperative hematoma or other bleeding complications. In contrast, the cases not using the LigaSure™ had greater blood loss as well as a higher rate of postoperative hematomas. Conclusions: The LigaSure™ provides excellent hemostasis with few complications when used for neurofibroma removal.</p>

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Pivoting distraction osteogenesis in hemifacial microsomia

Sakamoto Yoshiaki, Ogata Hisao, Nakajima Hideo, Kishi Kazuo, Sakamoto Teruo, Ishii Takenori

Journal of Plastic, Reconstructive and Aesthetic Surgery 65 ( 6 )  2012.06

ISSN  1748-6815

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The boomerang osteotomy - A new method of reduction malarplasty

Nakanishi Yuji, Nagasao Tomohisa, Shimizu Yusuke, Miyamoto Junpei, Kishi Kazuo, Fukuta Keizo

Journal of Plastic, Reconstructive and Aesthetic Surgery 65 ( 5 )  2012.05

ISSN  1748-6815

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<p>Background: To achieve optimal outcomes in reduction malarplasty, it is important to preserve the natural curvature of the cheek while reducing the zygoma prominence and the width of the midface. The present article introduces an effective technique that aims to achieve these purposes. Methods: Through an intraoral approach, boomerang-shaped bone incision lines are marked on the anterior aspect of the zygomatico-maxillary junction. The lines are placed medial to the most prominent part of the zygoma. The zygomatic arch is divided at its posterior part through a small incision made in the pre-auricular region. By performing these manoeuvres, a unit of bone-composed of a part of the zygoma body and zygomatic arch - is mobilised. The mobilised bone is shifted medially, reducing the width of the midface and making the zygoma region less prominent. After performing reduction malarplasty for 89 patients (10 males and 79 females) using this technique, clinical outcomes were evaluated. Results: Outcomes of the treatment was optimal, with over 80% of the patients evaluating the results as excellent in terms of effectiveness in malar prominence, facial width and symmetry. Conclusion: Because the continuity of the main part of the zygoma body and zygomatic arch is preserved in our technique, medial transfer of the zygoma is enabled while preserving the natural curvature of the malar region and the superior-inferior position of the zygomatic arch. Because of these advantages, we recommend our technique as an effective technique of reduction malarplasty.</p>

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A case of congenital unilateral amastia

Hatano Asako, Nagasao Tomohisa, Sotome Keiichi, Shimizu Yusuke, Kishi Kazuo

Journal of Plastic, Reconstructive and Aesthetic Surgery 65 ( 5 ) 671 - 675 2012.05

ISSN  1748-6815

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<p>Numerous reports have been published regarding the reconstruction of the breast, but the majority of these reports focus on breast reconstruction for defects caused by the removal of breast cancers. The authors treated a rare case of unilateral amastia where a 54-year-old female had a complete absence of the breast on one side, though the breast on the other side was intact. The defect was reconstructed successfully with a transverse rectus abdominis myocutaneous flap (TRAM) flap. The present study introduces this rare case with reference to past reports of amastia.</p>

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Recruited minced skin grafting for improving the skin appearance of the donor site of a split-thickness skin graft

Simizu Ruka, Kishi Kazuo, Okabe Keisuke, Uchikawa Yumiko, Sakamoto Yoshiaki, Hattori Noriko, Imanishi Nobuaki

Dermatologic Surgery 38 ( 4 ) 654 - 660 2012.04

ISSN  1076-0512

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<p>OBJECTIVE: To improve skin appearance at the donor site of a split-thickness skin graft, part of the harvested skin was minced and grafted back onto the site in a process we named "recruited minced skin grafting." MATERIALS AND METHODS: Thirteen Japanese patients who needed split-thickness skin grafts were treated with recruited minced skin grafting. Five patients were used as controls, in whom donor sites were treated with the traditional method. Part of the split-thickness skin was minced using two surgical blades (number 24) to an approximate particle size of less than 0.5 mm. Minced skin was spread and transplanted onto the donor site and covered with polyurethane foam. Twelve months after the operation, donor sites were scored for hypopigmentation, hyperpigmentation, redness, and disruption of skin texture. Gross appearance was evaluated according to total score. RESULTS: Donor sites treated with recruited minced skin grafts had significantly better appearance than those of controls. Donor sites that had more than 5% of the total area treated tended to have better results. CONCLUSION: Recruited minced skin grafting is a good method of improving the appearance of the donor site.</p>

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Recruited Minced Skin Grafting for Improving the Skin Appearance of the Donor Site of a Split-Thickness Skin Graft

Simizu, Ruka, Kishi, Kazuo, Okabe, Keisuke, Uchikawa, Yumiko, Sakamoto, Yoshiaki, Hattori, Noriko, Imanishi, Nobuaki

DERMATOLOGIC SURGERY 38 ( 4 ) 654 - 660 2012.04

Research paper (scientific journal),  ISSN  1076-0512

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New classification scheme of proboscis lateralis based on a review of 50 cases

Sakamoto Yoshiaki, Miyamoto Junpei, Nakajima Hideo, Kishi Kazuo

Cleft Palate-Craniofacial Journal 49 ( 2 ) 201 - 207 2012.03

ISSN  1055-6656

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<p>Background: Among congenital nasal deformities, proboscis lateralis is one of the rarest. Boo-Chai classified proboscis lateralis into four groups. Recently, we encountered a new case of proboscis lateralis with median cleft lip. We noticed that this classification had not been considered according to convalescence and embryologics, and further refinement seemed to be needed. Methods: We reviewed all cases of proboscis lateralis reported in English through 2009 and classified them by intercanthal distance. Results: A total of 34 studies involving 50 cases were reviewed. Six cases were identified as having normal intercanthal distance. Three of them presented nose abnormalities and fit Boo-Chai group II category. The other three were consistent with group I. Hypertelorism was observed in 27 cases and was further divided into two groups based on the occurrence of a frontal encephalocele. Seventeen cases without a frontal encephalocele were compatible with Boo-Chai groups III and IV. The other 10 cases associated with a visible encephalocele had encephalopathy; most died at an early age, and long-term survival cases suffered developmental delay and mental retardation. Seventeen cases were defined as hypotelorism, and all cases also presented as holoprosencephaly. Conclusions: The redefined classification contains two new groups: group V as hypertelorism with encephalocele and group VI as hypotelorism. A new classification scheme is proposed as not only convenient for clinical application but also embryologically accurate.</p>

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New Classification Scheme of Proboscis Lateralis Based on a Review of 50 Cases

Sakamoto, Yoshiaki, Miyamoto, Junpei, Nakajima, Hideo, Kishi, Kazuo

CLEFT PALATE-CRANIOFACIAL JOURNAL 49 ( 2 ) 201 - 207 2012.03

Research paper (scientific journal),  ISSN  1545-1569

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The formation of an angiogenic astrocyte template is regulated by the neuroretina in a HIF-1-dependent manner

Nakamura-Ishizu, Ayako, Kurihara, Toshihide, Okuno, Yuji, Ozawa, Yoko, Kishi, Kazuo, Goda, Nobuhito, Tsubota, Kazuo, Okano, Hideyuki, Suda, Toshio, Kubota, Yoshiaki

DEVELOPMENTAL BIOLOGY 363 ( 1 ) 106 - 114 2012.03

Research paper (scientific journal),  ISSN  0012-1606

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