皮島の一部を脱上皮した遊離前外側大腿皮弁で腹壁を再建した臍部尿膜管癌の1例

皮島の一部を脱上皮した遊離前外側大腿皮弁で腹壁を再建した臍部尿膜管癌の1例

Journal of Japan Society of Plastic and Reconstructive Surgery


母指IP関節に生じた化膿性関節炎・骨髄炎に対して血管柄付第Ⅱ趾PIP関節移植を用いた治療経験


〈症例〉巨大化するまで放置された大腿部脂肪肉腫に対する姑息的遊離皮弁移植術

〈症例〉巨大化するまで放置された大腿部脂肪肉腫に対する姑息的遊離皮弁移植術

日本マイクロサージャリー学会会誌

日本マイクロサージャリー学会会誌


リンパ節転移を伴った mucinous carcinoma of the skin の1例


Serum albumin levels correlate with inflammation rather than nutrition supply in burns patients : a retrospective study

The aim of this retrospective study was to examine whether serum albumin levels offer a good marker of nutritional status in patients with burns. Serum albumin levels have been used to evaluate nutritional status in burns patients, even though these levels are affected by various factors and are not specific to malnutrition. To clarify whether provision of nutrition or presence of inflammation affects serum albumin levels, we studied serum albumin levels, C-reactive protein (CRP) levels and caloric intake over time in 30 patients with burns. Serum albumin levels did not respond to provision of nutrition, but correlated negatively with CRP levels, suggesting that serum albumin levels are more closely associated with inflammation than nutrition. This study also suggests that hypoalbuminemia is a good indicator of the severity of burns or associated complications. We conclude that serum albumin levels do not offer a good nutritional marker in burns patients.

The Journal of Medical Investigation : JMI


Limb salvage and vascular augmentation by microsurgical free flap transfer for treatment of neuropathic diabetic foot ulcers

Neuropathic diabetic foot ulcers are generally deep and infectious wounds extending to the bone or joint. We performed microsurgical free flap transfer for limb salvage and vascular augmentation of feet with diabetic neuropathy. Angiography was performed to identify any significant arterial disease. The free flaps were transplanted after resection of the damaged skin and infected bone. Flow-through or end-to-side anastomosis to the dorsalis pedis artery was performed to preserve the arterial blood flow to the residual foot. An anterolateral thigh flap and free flaps based on the subscapular artery system were transplanted in 1 and 10 patients, respectively. All flaps survived. Arterial flow on the distal side of the anastomosis was postoperatively confirmed in all patients. During a mean follow-up period of 52 months, the long-term complications observed were recurrent ulcers in 4 patients. The limb salvage rate was 100%, and 82% of patients achieved functional ambulation. Microsurgical flap transplantation is a safe and useful technique for minimal amputation of a diabetic neuropathic foot. Postoperative protection of the feet is important in order to avoid recurrence of foot ulceration. The use of protective footwear custom-tailored for each patient is strongly recommended.


Three-dimensional sodium chloride (NaCI) model for simulated mandibular reconstruction surgery : a new environmentally friendly material

Mandibular reconstruction using a fibular graft is a difficult procedure that requires technical expertise to enable adequate occlusal function and restore an aesthetic appearance. Here we used three-dimensional (3D) sodium chloride (NaCl) models for simulated mandibular reconstruction surgery. This study aimed to reveal the accuracy of mandibular reconstruction with fibular grafts using this model. Mandibular reconstructions using 3D NaCl models were performed in 5 cases. The maxilla, mandible, and fibular models were developed using computed tomography (CT) data. We performed preoperative cutting and simulation surgery using this model. Angles between the body of the corpus and symphysis were measured from the axial view (n = 4). Angles between the ramus and the body of the corpus were measured from the lateral and axial views (n = 6). These angles were measured on simulated models and postoperative CT images were compared. Differences between the angles measured on the simulated models and postoperative CT images were 0-5° (mean, 1.9°). We were able to reproduce the neomandibles with precise osteotomies using the 3D NaCl models. We believe that simulated mandibular reconstruction surgery using this model might help reduce the number of intraoperative neomandibular segment adjustments.


Two cases of sacral pressure ulcer with a combination of surgery and semi-prone position

半腹臥位療法と手術を併用した仙骨部褥瘡2症例の治療経験


Overexpressed HIF-2α in Endothelial Cells Promotes Vascularization and Improves Random Pattern Skin Flap Survival.

Specific overexpression of HIF-2 in ECs promoted vascularization and enhanced skin flap survival in vivo in a mouse model.

Plastic and Reconstructive Surgery. Global Open


Chronic inflammation and progressive calcification as a result of fat necrosis : the worst end in fat grafting.

Autologous fat injection into the breast has been performed widely for breast augmentation and reconstruction because of recent technical and scientific advancements. However, it is important to learn what occurs and how problematic it can be if fat grafting is not conducted appropriately. Oil cysts were explanted from three subjects who underwent cosmetic fat grafting to the breast 2, 4, and 6 years previously. The oil cyst samples were examined histopathologically. Computed tomographic, magnetic resonance imaging, and mammographic images obtained sequentially after fat grafting were also analyzed. The cyst wall consisted of innermost and outermost fibrous layers and intermediate tissue that contained the regular adipose portion, a degenerated adipose portion, and a fibrous area. Eggshell-like macrocalcifications were seen in the inner surface. Numerous inflammatory cells, mainly MAC2/CD206 anti-inflammatory M2 macrophages, were observed in the degenerated adipose portion. Oil cysts with a longer history showed more calcifications in the innermost layer and a larger fibrous area adjacent to the degenerated fat portion than those with a shorter history. These histopathologic findings and clinical computed tomographic images revealed that oil cysts continued to be inflammatory and calcifications continued to develop over several years. After fat necrosis, long-term chronic inflammation persists and calcification seems to progress without limits. Oil cysts are the worst outcome of fat grafting and must be avoided by standardizing meticulous injection techniques. Therapeutic, V.


Risk factors for complications after reconstructive surgery for sternal would infection


The Internal Pudendal Artery Perforator Thigh Flap : A New Free Style Pedicle Flap for the Ischial would infection

Recurrence and complication rates of pressure sores are highest in the ischial region, and other donor sites are needed for recurrent pressure sores. The potential of a new freestyle pedicle flap for ischial lesions, an internal pudendal artery perforator (iPap) thigh flap, was examined through anatomical and theoretical analyses and a case series using computed tomography angiography. The skin flap was designed in the thigh region based on an iPap. The skin perforators were marked with a Doppler probe. One patient underwent computed tomography angiography with fistulography to identify the damage to or effects on the pedicle vessels of the flap. Debridement of ischial lesions and flap elevation were performed in the jackknife position. The iPap thigh flaps were performed in 5 patients, 4 with ischial pressure sores and 1 with calcinosis cutis of the ischial region. The width and length of the flaps ranged from 5 to 8 cm (mean, 6.6 cm) and 10 to 17 cm (mean, 12.6 cm), respectively. Three patients underwent partial osteotomy of the ischial bone. No complications, including flap necrosis or wound dehiscence of the donor and reconstructed sites, were observed. The perforator vessels of the internal pudendal artery are very close to the ischial tuberosity. Blood flow to the flap is reliable when careful debridement of the pressure sore is performed. The iPap thigh flap is a new option for soft-tissue defects in the ischial region, including ischial pressure sores.


臀部コレステリン肉芽腫の1例

臀部コレステリン肉芽腫の1例


The Internal Pudendal Artery Perforator Flap : Free-style Pedicle Perforator Flaps for Vulva, Vagina, and Buttock Reconstruction

Reconstruction of the vulva, vagina, and buttocks following cancer ablation is challenging. Restoring the shape, volume, and function is the key to the best reconstruction for these regions. Perineal reconstruction with a free-style flap based on skin perforators from the internal pudendal artery was evaluated. The internal pudendal artery perforator flap was designed based on information about the skin perforators. The flap base contained the arterial sounds, which were identified by a handheld Doppler device, on and around the ischiorectal fossa. Types of flaps used included propeller flaps, traditional transposition flaps, and V-Y advancement flaps. Seventy-one flaps were transplanted in 45 cases. The reconstructed regions included vulvar skin in 36 cases, buttock skin in 10 cases, vagina in nine cases, anus in six cases, and pelvic cavity in six cases. The flaps were transplanted in the lithotomy or prone position. Sixty-seven of these flaps survived completely. Four flaps showed partial necrosis, but no total flap failures occurred. Thinning of the fatty tissue of the flap was performed in all cases except pelvic cavity reconstruction. An additional operation to remove bulkiness of the flaps following the initial reconstruction was required in one case. Propeller flaps, transposition flaps, and V-Y flaps were used in 35, three, and seven cases, respectively. This study revealed that the blood circulation of this flap is reliable and that it offers suitable volume not only for vulvar, vaginal, and anal reconstruction, which requires a thin flap, but also for pelvic floor reconstruction, which requires flap volume. Therapeutic, IV.


Effect of the Biopsy Technique on the Survival Rate of Malignant Melanoma Patients

Cutaneous malignant melanoma has a poor prognosis. The detrimental effect of incisional biopsies on the outcome of malignant melanoma has been debated. The aim of this study was to determine the effect of the presence and type of biopsy on the prognosis of malignant melanoma. The medical records of 109 malignant melanoma patients treated at Tokushima University Hospital from 1983 to 2007 were reviewed. After excluding 28 cases with stage 0 disease or incomplete data, 81 cases were analyzed in detail with respect to patient sex, age, tumor site, clinical stage at diagnosis, presence of ulceration or lymph node metastasis, and prognosis. The five-year survival and five-year disease-free survival rates of patients who underwent incisional or excisional biopsies were compared with those who did not undergo a biopsy. The male-to-female ratio was 1:1.19. The mean age was 61.3 years (range, 19-93 years). The most common site was a lower extremity, and the most common clinical stage was stage II. No significant differences in clinicopathological features, five-year survival rates, and five-year disease-free survival rates were observed among the three groups. The presence and type of biopsy neither affected the metastatic rate nor the prognosis of malignant melanoma. The use of incisional biopsies is not encouraged because tumor thickness cannot be measured accurately. However, they may be helpful for confirming the diagnosis if an excisional biopsy cannot be performed.


Extended Hair-bearing Lateral Orbital Flap for Simultaneous Reconstruction of Eyebrow and Eyelid

When a tumor in the lateral eyebrow region is resected, reconstruction of the eyebrow and upper eyelid defects is necessary. We perform simultaneous reconstruction of such defects; sideburn hair is included on an extended lateral orbital flap. We describe our method and results of a retrospective evaluation. We treated 6 patients with partial eyebrow and upper eyelid defects. An extended lateral orbital flap was designed on the lateral region of the lateral canthus including sideburn hair and was elevated with a pedicle of the orbicularis oculi muscle. Flap size, surgical outcomes, and reconstructed eyebrow morphology were evaluated. Mean flap size was 2.7 × 4.1 cm, with a maximum width and length of 3.5 and 5.1 cm, respectively. The mean hair-bearing region was 1.4 × 0.9 cm, with a maximum width and length of 1.8 and 1.3 cm, respectively. Total flap survival and hair growth were confirmed in all patients. The reconstructed eyebrow and eyelid were aesthetically satisfactory. The new eyebrow hair grew long and was directed upward but considered acceptable. No additional surgery was performed for any patient. The donor site scar was acceptable because it followed the wrinkles of the lateral eyelid. No paralysis of the temporal branch of the facial nerve resulted. The procedure for raising an extended hair-bearing lateral orbital flap is relatively easy, although attention must be paid to the temporal facial nerve. This flap is useful for simultaneously reconstructing defects of the upper eyelid and lateral eyebrow.


Relation between the serum albumin level and nutrition supply in patients with pressure ulcers : retrospective study in an acute care setting

This retrospective study examined the validity of the commonly used serum albumin level as an indicator of nutrition status of patients with pressure ulcer(s), particularly because the serum albumin level is affected by various factors and may not be specific to malnutrition. Specifically, we investigated whether nutrition supply or inflammation affects the serum albumin level in 82 patients with pressure ulcers(s) (29 in whom pressure ulcer was present upon admission and 53 in whom pressure ulcer developed after hospital admission). Serum albumin levels, blood test including C-reactive protein (CRP) levels and blood count, caloric intake, and depth and healing of pressure ulcers were compared between various subgroups of patients. Serum albumin levels correlated with red blood cell counts and hemoglobin and CRP levels but not with caloric intake. The correlation with CRP before and after several weeks of pressure ulcer treatment was negative. The serum albumin level upon admission was higher in patients in whom the ulcer healed than in those in whom it did not heal as well as in patients who were discharged than in those who died in the hospital. The serum albumin level appears to reflect inflammation, wound healing, and disease severity rather than nutrition supply in patients with pressure ulcer. J. Med. Invest. 61: 15-21, February, 2014.

The Journal of Medical Investigation : JMI


Two-Stage Surgery for Hidradenitis Suppurativa : Staged Artificial Dermis and Skin Grafting

Hidradenitis suppurativa is a chronic and often refractory skin disease that can require radical excision of the full layer of fatty tissue under the lesion. Closure using a split-thickness skin graft often results in depression deformity and lack of tissue flexibility. We have developed a two-stage procedure to preserve fatty tissue during radical excision and apply an artificial dermis graft, and we have performed this procedure in 18 patients (33 lesions). To describe our two-stage procedure and report results of the procedure in our patient series. In the first step, all diseased skin including the superficial subcutaneous fatty tissue is excised; normal deep subcutaneous fatty tissue is preserved. Artificial dermis is then grafted to the preserved fatty tissue. Two weeks later, split-thickness skin grafts are applied to the skin defects. We evaluated graft success, any recurrence, and postoperative appearance in our patients, who were followed up for 8 to 36 months. All 32 skin grafts were successful. There was only one recurrence, which was treated using reoperation, and postoperative appearances were good. Our new procedure incorporating artificial dermis appears to be a good treatment option for advanced hidradenitis suppurativa.


顎顔面領域における骨治癒に対する低出力超音波パルス照射の使用経験

顎顔面領域における骨治癒に対する低出力超音波パルス照射の使用経験


A Report on Propranolol Treatment for Four Cases of Infantile Hemangioma

乳児血管腫に対しプロプラノロール内服治療を行った4例

Journal of Japan Society of Plastic and Reconstructive Surgery


Analysis of the Correlation between Wound Contraction Ratio and Therapeutic Duration Using V.A.C. ATS Therapy System for 34 Cases

V.A.C. ATS治療システムを使用した創傷34例の検討ー創の収縮率とV.A.C.使用期間に関する検討ー


Two cases of pressure ulcers healed using undermining skin as a bipedicle flap

症例 ポケット皮膚を双茎皮弁として治療した褥瘡の2例


A Case of MALT Lymphoma in the Accessory Parotid Gland

副耳下腺に生じたMALTリンパ腫の1例


A Case of Nodular Fasciitis with Retraction of the Overlying Skin of the Cheek

頬部陥凹を呈した頬部結節性筋膜炎の1例

Journal of the Japan Society of Cranio-Maxillo-Facial Surgery

日本頭蓋顎顔面外科学会誌


ポケット上の皮膚を双茎皮弁として用いることで治癒し得た背部褥瘡の1例

ポケット上の皮膚を双茎皮弁として用いることで治癒し得た背部褥瘡の1例


Systemic Preconditioning by a Prolyl Hydroxylase Inhibitor Promotes Prevention of Skin Flap Necrosis via HIF-1-Induced Bone Marrow-Derived Cells.

We demonstrated that transient activation of the HIF signaling pathway by a single systemic DMOG treatment upregulates not only anti-apoptotic pathways but also enhances neovascularization with concomitant increase in the numbers of bone marrow-derived progenitor cells.


Recurring facial low-grad fibro myxoid Sarcoma in an elderly patient : A cace report

Low-grade fibromyxoid sarcoma (LGFMS) is a rare type of sarcoma that is characterized by benign-appearing histologic features but a paradoxically aggressive clinical course. These tumors generally occur in young to middle-aged adults, sometimes in children, but rarely in high-aged adults. LGFMS typically affects the deep soft tissues of the trunk or lower extremities; however, it is rarely seen in the face. We here describe a case of LGFMS on the right forehead of an 84-year-old woman. After resection with a 1-cm skin margin, recurrence occurred at 15 months postoperatively. Additional wide excision was subsequently performed with a 2-cm skin margin. Recurrence and metastasis have not been observed for 1 year after the second excision. A wide surgical margin should be considered in cases of LGFMS.


The Final Step in Board Certification for Plastic Surgery : Malignant Skin Tumor

連載 専門医取得に必要な形成外科手技―口頭試問への対策―[第8回]皮膚悪性腫瘍


下殿動静脈を移植床血管とし遊離広背筋皮弁で再建した仙腸関節部放射線潰瘍の1例

下殿動静脈を移植床血管とし遊離広背筋皮弁で再建した仙腸関節部放射線潰瘍の1例

日本マイクロサージャリー学会会誌

日本マイクロサージャリー学会会誌


顔面に発生し，皮下と筋肉内に浸潤した結節性筋膜炎の1例

顔面に発生し，皮下と筋肉内に浸潤した結節性筋膜炎の1例


Importance of Skeletal Morphology Around the Nasal Cavity and the Alveolar Cleft for Alveolar Bone Grafting

<原著>顎裂骨移植における梨状孔から顎裂にかけての骨形態の重要性

日本頭蓋顎顔面外科学会誌


<原著>下顎プレート再建術における外側広筋と大腿筋膜を付着させた遊離前外大腿連合皮弁の有用性

日本頭蓋顎顔面外科学会誌


A Case of Lower Leg Pseudoainhum with Rubber Bands

輪ゴムによる高度下腿仮性絞扼症の1例


Early postoperative evaluation of secondary bone grafting into the alveolar cleft and its effects on subsequent orthodontic treatment

Alveolar bone grafting is a standard procedure used to achieve good occlusion for both functional and aesthetic purposes in patients with cleft lip and palate. At the past, main methods used to evaluate bone bridge formation after bone grafting are radiographs, such as dental, occlusal, and panoramic. To evaluate bone bridge both qualitatively and quantitatively, we used CT scans (conventional and QCT). Quantitative computed tomography (QCT) has previously been used for measuring bone mineral density of the lumbar vertebrae. The study comprised 26 male and 15 female patients who underwent alveolar bone grafting. We analyzed bone bridge with regard to four factors: marginal bone level, vertical height, anteroposterior bone width and bone mineral density using dental radiographs, and CT scans such as conventional and QCT. The clinical results of orthodontic treatment were evaluated more than 2 years postoperatively. Orthodontic treatment was considered to be successful when the bone bridge satisfied the following criteria: marginal bone level >= 3, vertical height >= 6.5 mm, anteroposterior bone width >= 5 mm, and bone mineral density < 350 mg Ca(5) (PO(4)) OH/mL. we could predict the prognosis of patients' orthodontic treatment in early stage after bone grafting.

The Journal of Medical Investigation : JMI


Usefulness in combined free anterolateral thigh and vastus lateralis muscle flaps


原発性リンパ浮腫診断治療指針2012年版9.リンパ原発性リンパ浮腫:その他の侵襲的治療9-2リンパ誘導術 2)遊離筋皮弁


Journal of Japan Society of Plastic and Reconstructive Surgery


A clinicopathological study of primary cutaneous invasive squamous cell carcinoma: relationship between a new clinicopathological classification and program

皮膚原発浸潤性有棘細胞癌(Primary Cutaneous Invasive Squamous Cell Carcinoma)の臨床病理学的検討:臨床病理学的新分類と予後の関係

We performed a clinicopathological analysis of 305 cases of primary cutaneous invasive squamous cell carcinoma (SCC) diagnosed in Tokushima University hospital in the past 25 years. We proposed a new clinicopathological classification of SCC based on epidemiological factors and divided it into nine categories; actinic keratosis type, bowen type, keratoacanthomatous type, cystic type, genital type, cicatricial type, radiodermatitis type, xeroderma pigmentosa type, and miscellaneous type. We examined the clinicopathological characteristics in each category such as favorite locations and prognosis. Among the clinical characteristics of those cases, such as sex ratio and age at the time of the excision, the favorite sites were similar to those in former reports in Japan. The actinic keratosis type is a significant type with little metastasis, but the radiodermatitis type and the genital type showed high metastatic rates. The case that occurred on the face showed little metastasis, but the cases on the lower limbs and genitalia had high metastatic rates. Cases with a tumor thickness of less than 4 mm showed lower metastatic rates than those with a tumor thickness of more than 4 mm. We divided those 25 years into five year segments as investigation periods and examined the numbers of cases, sex ratios, and the frequencies of the actinic keratosis type, the Bowen disease type, and the other types and found that these factors were essentially equal.

1983年から2007年の25年間で，徳島大学病院皮膚科および形成外科で経験した皮膚原発浸潤性有棘細胞癌305例について，特に発症要因を重要視した臨床病理学的新分類法を用いて分類し，日光角化症型，Bowen病型，ケラトアカントーマ型，嚢腫型，外陰部型，瘢痕型，放射線皮膚炎型，色素性乾皮症型，その他，の9型に分類した．各型に関して好発部位や転移の有無/予後の違いなどの臨床病理学的検討を行った．その結果，症例全体の臨床的特徴は，男性に多く発生していること，切除時年齢，発生部位の割合など，本邦における以前の報告とほぼ同様であった．さらに病型では，日光角化症型は転移を起こしにくく，外陰部型・放射性皮膚炎型は転移を起こしやすかった．次に発生部位では顔面に生じたものは転移を起こしにくく，下肢・外陰部に生じたものは転移を起こしやすかった．腫瘍の厚さでは4 mm未満の症例は転移を起こしにくく，4 mm以上の症例は転移を起こしやすかった．調査した25年間を5年毎に区切り，各年代における日光角化症型，Bowen病型，それ以外のタイプの4群の症例数の推移と男女比を調査したが，その構成に大きな変化はなかった．


特集 Local flap method 会陰部臀部のlocal flap method


Long-term stability of LeFort III distraction osteogenesis with a rigid external distraction device in a patient with Crouzon syndrome.

A 6-year-old boy, diagnosed with Crouzon syndrome, had moderate exorbitism, a concave profile, an anterior crossbite of -4.0 mm, and a skeletal Class III jaw-base relationship caused by midfacial hypoplasia. At age 8 years 9 months, a LeFort III osteotomy was performed, and distraction osteogenesis was immediately started with the rigid external distractor system. The midface was advanced approximately 10.0 mm for 6 days, including overcorrection. After the distraction, a reverse headgear was used for 6 years to prevent relapse and to accelerate expected growth. At age 16 years 5 months, after extraction of the maxillary first premolars and mandibular third molars, 0.022-in preadjusted edgewise brackets were placed to treat the edge-to-edge incisor relationship and minor crowding. After 13 months of treatment, the facial profile was significantly improved, and an acceptable occlusion was achieved. During the 9-year observation period after the distraction, acceptable facial growth occurred, and no relapse of the maxillary advancement was observed. However, syndrome-specific growth and methodologically induced relapse should be considered when planning a LeFort III distraction in children for the treatment of Crouzon syndrome.

American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO)


A patient who developed toe necrosis due to poor blood circulation after an interdigital tick bite.


前額部開頭術後変形に対するリン酸カルシウム骨ペーストと側頭筋骨膜弁による再建

前額部開頭術後変形に対するリン酸カルシウム骨ペーストと側頭筋骨膜弁による再建

Journal of the Japan Society of Cranio-Maxillo-Facial Surgery

日本頭蓋顎顔面外科学会誌


術後唾液瘻に対するOK-432の使用経験

術後唾液瘻に対するOK-432の使用経験


褥瘡患者において血清アルブミン値は栄養状態を表す良い指標か?

褥瘡患者において血清アルブミン値は栄養状態を表す良い指標か?

The Journal of Metabolism and Clinical Nutrition


筋強直性ジストロフィーを合併した多発性石灰化上皮腫の1例

筋強直性ジストロフィーを合併した多発性石灰化上皮腫の1例


IgG4関連硬化性疾患患者に発症したPhotobacterium damselaによる壊死性筋膜炎の1例


Pencil-core granulome of the face:Report of two rare cases

Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS


Calcifying aponeurotic fibroma of the elbow:a case report

Calcifying aponeurotic fibroma is a rare soft tissue tumor that typically occurs in the distal extremities of children and adolescents. Because a calcifying aponeurotic fibroma is an ill-defined mass and has a tendency to infiltrate the surrounding tissue, local recurrence rates are 50%. We report a case of calcifying aponeurotic fibroma occurring in the elbow region, an uncommon site. The patient is followed up for 6 years without local recurrence of the tumor.

The Journal of Medical Investigation : JMI


糖尿病性足潰瘍瘍(神経障害型)に対する遊離皮弁移植による患肢温存法

糖尿病性足潰瘍瘍(神経障害型)に対する遊離皮弁移植による患肢温存法

日本マイクロサージャリ―学会会誌

日本マイクロサージャリ―学会会誌


Experience of using Harmonic focus in our department


陰圧式体位保持具使用に関する術中褥瘡の1例

陰圧式体位保持具使用に関する術中褥瘡の1例


特集/体表悪性腫瘍の部位別治療戦略 外陰殿部癌

特集/体表悪性腫瘍の部位別治療戦略 外陰殿部癌


Severity of alveolar cleft affects prognosis of infant orthopedics in complete unilateral cleft lip and palate: three-dimensional evaluation from cheiloplasty to palatoplasty.

The purpose of this study was to investigate the relationships between severity of alveolar cleft and treatment outcome of infant orthopedics in patients affected by complete unilateral cleft lip and palate from cheiloplasty to palatoplasty with a three-dimensional evaluation method. Treatment outcomes of infant orthopedics were evaluated using three-dimensional linear and angular measurements of plaster models after cheiloplasty (T1) and before palatoplasty (T2). Eleven patients who had a width of alveolar cleft (WC) less than 4.0 mm at T1 (mild group) and 13 patients who had a WC 4.0 mm or greater (severe group) were compared and analyzed. From T1 to T2, the lengths of the alveolar segments were increased, and the WC was decreased without palatal collapse of alveolar segments in both groups. However, the WC in the severe group was significantly decreased by increased growth of the major segment compared with the mild group. The incisive papilla had a more evoked growth to the alveolar cleft side than in the severe group. Conclusively, infant orthopedics was quite useful in reducing WC in patients affected by unilateral cleft lip and palate after cheiloplasty, and the severity of WC significantly affected the prognosis of infant orthopedics.


Resin splint as a new conservative treatment for ingrown toenails.

Several conservative as well as surgical methods are used for the treatment of ingrown toenails until date. The conservative methods are either based on nail splinting or on orthonyxia, but no methods employing both principles have been reported thus far. Moreover, surgical methods usually involve postoperative pain, prolonged wound healing and restricted activities of daily living. Therefore, considering the need of a simplified, non-invasive method, in this study, we applied a novel splint to treat patients with ingrown toenails and estimated the clinical efficacy as well as rate of recurrence following treatment. The splint is a plate made of resin that is attached to the lateral edge of the nail using a bandage. We studied 61 patients (19 men and 42 women; mean age 36 years), with an average application duration of 9.3 months and an average follow-up period of 10 months in all patients. All patients experienced pain relief within a week of splint application and a decrease in the degree of nail deformity. Moreover, follow-up revealed a recurrence rate of 8.2%. Therefore, we believe that this new device is an excellent conservative treatment method for patients with ingrown toenails.


悪性腫瘍切除後の眼瞼再建

悪性腫瘍切除後の眼瞼再建


Injection injury caused by puncture of nozzle of a spray can

We present a case of low-pressure injection injury of the left index finger caused by puncture of the nozzle of a spray can. It resulted in symptoms as severe as those from a high-pressure injection injury. Several debridements meant that the finger did not have to be amputated. The raw surface was covered with a V-Y advancement flap.

Journal of Plastic Surgery and Hand Surgery


表皮囊腫から発生したオトガイ部有棘細胞癌の1例

表皮囊腫から発生したオトガイ部有棘細胞癌の1例

Journal of Japan Society of Plastic and Reconstructive Surgery


レックリングハウゼン氏病患者の吊り上げ術の工夫

レックリングハウゼン氏病患者の吊り上げ術の工夫

Journal of the Japan Society of Cranio-Maxillo-Facial Surgery

日本頭蓋顎顔面外科学会誌


Prevention of pressure ulcers in home care patients

きず・きずあと(創傷)治療:最近の進歩床ずれの在宅ケア

A large proportion of home care patients are at risk of pressure ulcer. The occurrence rate of pressure ulcer is higher in home care patients than that in the patients of hospitals and welfare facilities. The home care patients need long-term conservative treatment because of the depth of the pressure ulcers.Treatment of the pressure ulcers at home results in increase of caregivers burden. Therefore,prevention and early detection of pressure ulcers are important in home nursing. In early stage of pressure ulcers，``deep tissue injury''should be taken into consideration because of its progressive nature. It is a new concept which presents deep tissue damage remaining superficial skin intact.One of clinical features in this condition is induration in a deep layer.The past decade has seen a huge growth in the application of pressure relieving mattresses,absorbent products for urinary and faecal incontinence, and skin barrier products to prevention of the pressure ulcers. Economical, physical, and psychological burden of nursing at home should be decreased with an accumulation of these information and utilization of the products. Therefore, it is important for caregivers to consult with their care managers and acquire new knowledge and information.


Is the common knowledge true in wound healing?

きず・きずあと(創傷)治療:最近の進歩けが・やけど治療の常識と非常識

Disinfection of wound with povidone-iodine was thought to be very effective to wound healing.Nowadays wound infection is thought in the idea of bacterial balance, which means that bacteria are increasing in three phases`: contamination',`colonization'and`infection'. In the phases of`contamination'and`colonization', the bacteria do not harm to the wound and disinfectants are not necessary but wound irrigation is recommended. In the phase of`infection', redness, swelling,local fever and tenderness are observed and disinfectants are needed.Dry condition was thought to be effective for wound healing to control the bacterial infection.However, it has been revealed that wound healing process is very complicated and needs many cells, growth factors and cytokines. Moist environment is useful for the movement of cells and factors to heal the wound.


当科における炊飯器による小児手指熱傷の検討

当科における炊飯器による小児手指熱傷の検討


Flap transplantation for scar contracture in the perineal region

外陰部瘢痕拘縮に対する皮弁再建


頭部・顔面における神経線維腫症の治療

頭部・顔面における神経線維腫症の治療


A Case of Branchial Cyst of the Right Parotid Gland

右耳下腺に発生した鰓原性嚢胞の1例

日本頭蓋顎顔面外科学会誌


Free Flap Transfer to Foot Ulcer Based on Diabetic Neuropathy Using Flow-through Type Anastomosis

神経障害型糖尿病足潰瘍に対する患肢温存と血流付加のための遊離皮弁移植術

日本マイクロサージャリー学会会誌

日本マイクロサージャリー学会会誌


Rhabdomyosarcoma : A Report of Two Cases

顔面に発生した横紋筋腫の治療経験

日本頭蓋顎顔面外科学会誌


Flap transplantation and skin graft for perineal reconstruction after resection of malignant tumor

悪性腫瘍切除後の外陰会陰部再建における皮弁術と植皮術

We analysed 55 patients who underwent perineal reconstruction after malignant tumor resection in the department of plastic and reconstructive surgery in the Tokushima University Hospital. This group comprised 19 male and 36 female patients. There were 18 patients with squamous cell carcinoma, 25 with extramammary Paget's disease, 2 with malignant melanoma, 1 with basal cell carcinoma and 9 with other tumors. The defects were reconstructed with skin graft in 12 cases and with flap transplantation in 43 cases. The transplanted flaps consisted of gluteal fold flap (internal pudendal artery perforator flap) in 31 cases, rectus abdominis flap (musculocutaneous flap) in 6, gluteus maximus muscle (perforator) flap in 3, and scrotum flap in 3. We had no recurrent case, and only one case who underwent flap revison.[Skin Cancer (Japan) 2009 ; 24 : 423-426]


特集:創傷治療，悪性腫瘍によるもの

特集:創傷治療，悪性腫瘍によるもの


Case Report of Right Leg Chemical Injury by Caustic Soda

苛性ソーダによる右下肢化学損傷の1例


Ⅱ．創傷外科各論 2．慢性創傷 4)褥瘡 d)褥瘡の外科的治療

Ⅱ．創傷外科各論 2．慢性創傷 4)褥瘡 d)褥瘡の外科的治療


Reconstruction of microtia with laser hair removal before transplantation of costal cartilarge

When scalp skin is contained in reconstruction of microtia, the hair growth on the reconstructed auricle causes aesthetic problems. Several techniques to deal with hairline, such as skin graft, skin flap, tissue expander and electroepilation, have been reported, but there are few reports using laser hair removal for microtia patients. We performed presurgical laser therapy in five patients. The low regions of hairlines in unilateral microtia children were irradiated by two kinds of laser systems for 1 year before the transplantation of costal cartilage. When hair growth was seen after the surgery, laser irradiations were performed. Video-microscopic and histological studies were examined to check the rates of epilation and skin injuries. There were no conspicuous hairs on the reconstructed ears and no side effects such as skin injury, folliculitis and deformity of cartilage. Video-microscopic examination revealed that terminal hair was rarely observed after irradiation, although the amount of vellus hair after irradiation was the same as that before irradiation. Histological examination showed that atrophy or hyperplasia of epidermis and dermis were not observed. Although patients had to undergo laser epilation from four to seven times because of a hair cycle, the laser epilation is less invasive and safer than other surgical procedures to reconstruct non-haired helix.

Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS


輪ゴムによる仮性紋扼症の1例

輪ゴムによる仮性紋扼症の1例


Targeted deletion of the murine corneodesmosin gene delineates its essential role in skin and hair physiology

Controlled proteolytic degradation of specialized junctional structures, corneodesmosomes, by epidermal proteases is an essential process for physiological desquamation of the skin. Corneodesmosin (CDSN) is an extracellular component of corneodesmosomes and, although considerable debate still exists, genetic studies have suggested that the CDSN gene in the major psoriasis-susceptibility locus (PSORS1) may be responsible for susceptibility to psoriasis, a human skin disorder characterized by excessive growth and aberrant differentiation of keratinocytes. CDSN is also expressed in the inner root sheath of hair follicles, and a heterozygous nonsense mutation of the CDSN gene in humans is associated with scalp-specific hair loss of poorly defined etiology. Here, we have investigated the pathogenetic roles of CDSN loss of function in the development of skin diseases by generating a mouse strain with targeted deletion of the Cdsn gene. Cdsn-deficient mouse skin showed detachment of the stratum corneum from the underlying granular layer and/or detachment within the upper granular layers due to the disrupted integrity of the corneodesmosomes. When grafted onto immunodeficient mice, Cdsn-deficient skin showed rapid hair loss together with epidermal abnormalities resembling psoriasis. These results underscore the essential roles of CDSN in hair physiology and suggest functional relevance of CDSN gene polymorphisms to psoriasis susceptibility.

Proceedings of the National Academy of Sciences of the United States of America


Involvement of Rab13 and JRAB/MICAL-L2 in epithelial cell scattering.

Epithelial cell scattering recapitulates the first steps of carcinoma invasion/metastasis. While the balance between cell-cell adhesive activity and cell motility ultimately determines this process, its molecular mechanisms remain unclear. Adherence junctions and tight junctions (TJs) are primarily responsible for cell-cell adhesive activity and subjected to dynamic remodeling. We previously showed that Rab13 and its effector protein JRAB/MICAL-L2 mediate the endocytic recycling of the integral TJ protein occludin and the assembly of functional TJs. In this study, we examined the role of Rab13 and JRAB/MICAL-L2 in the scattering of Madin-Darby canine kidney (MDCK) cells in response to 12-O-tetradecanoylphorbol-13-acetate (TPA). Knockdown of Rab13 in canine MDCK cells suppressed the TPA-induced scattering, and this phenotype was restored by re-expression of human Rab13. During TPA-induced MDCK cell scattering, Rab13 was transiently activated and returned to its basal level, and both Rab13 and JRAB/MICAL-L2 were colocalized with F-actin at cell-cell contact sites and then accumulated at emerging lamellipodial structures. TPA-induced MDCK cell scattering was also inhibited by knockdown of canine JRAB/MICAL-L2 and rescued by re-expression of mouse JRAB/MICAL-L2. These results indicate that Rab13 and JRAB/MICAL-L2 are involved in epithelial cell scattering.


顔面に発生したきわめて巨大な基底細胞癌の1例

顔面に発生したきわめて巨大な基底細胞癌の1例

Journal of Japan Society of Plastic and Reconstructive Surgery


連載「私の手術と合併症回避のコツ」会陰部悪性腫瘍手術ーGluteal fold flapによる再建手術を中心として―


眼瞼下垂をきたした眼瞼皮膚弛緩症の1例

眼瞼下垂をきたした眼瞼皮膚弛緩症の1例


顔面に発生したきわめて巨大な基底細胞癌の1例

顔面に発生したきわめて巨大な基底細胞癌の1例


遅発的に発症した術後深部静脈血栓症の1例

遅発的に発症した術後深部静脈血栓症の1例


人工骨が原因と考えられた乳様突起炎を合併した難治性瘻孔の1例

人工骨が原因と考えられた乳様突起炎を合併した難治性瘻孔の1例


臀部穿通枝皮弁で再建を行った滑液包炎の2例

臀部穿通枝皮弁で再建を行った滑液包炎の2例


質疑応答 形成外科 Venous lakeと血管腫の異同

質疑応答 形成外科 Venous lakeと血管腫の異同


Severe radiation-induced injury after cardiac catheter ablation:a case requiring free anterolateral thigh flap and vastus lateralis muscle flap reconstruction on the upper arm

Although cases of radiation-induced skin injury after fluoroscopically-guided procedures have been reported since 1996, diagnosis and treatment of such injury remain difficult. We present the case of a patient who complained of two ulcers, one on his right arm and one on his back, and limited motion of the right elbow joint after repeated cardiac radiofrequency catheter ablations. After resection of the skin ulcer on the patient's arm and of degenerated tissue in the distal part of the triceps brachii muscle, a combined free flap incorporating an anterolateral thigh flap and vastus lateralis muscle flap was transplanted. In the present case, this combined flap was very useful for simultaneous reconstruction of the muscle and skin defects under and over the tendon because the muscle flap and skin flap could be arranged separately.

Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS


特集臨床医学の展望2008-診断および治療上の進歩[4]形成外科学

特集臨床医学の展望2008-診断および治療上の進歩[4]形成外科学


熱傷瘢痕拘縮による小口症の治療経験

熱傷瘢痕拘縮による小口症の治療経験


乳房縮小・再建術を行った若年性乳腺肥大症の2例

乳房縮小・再建術を行った若年性乳腺肥大症の2例


Analysis of skin graft survival using green fluores cent protein transgenic mice

Skin grafting has become a basic and established operation technique; however, it is not clear how skin grafts adapt to recipient beds and replace their functions. In this study, we analyzed the origin of cells in adapted transplants by using green fluorescent protein (GFP) transgenic mice, which emits green fluorescence in the whole body. The dorsal skins of GFP transgenic mice were transplanted to the back of wild-type mice. Similarly, wild-type skins were transplanted to the back of GFP transgenic mice. Since transplantation with full thickness back skin was not successful due to severe immunorejection, tail skins, which contain fewer epidermal Langerhans cells, were used for the experiments. Six months after transplantation, immunohistochemical analysis of the grafts revealed that tissues derived from ectodermal origin such as the epidermis, hair follicles, and sebaceous glands survived in transplanted grafts, but that other tissues such as the dermis, nerves and blood vessels are partly replaced by tissues from recipient beds. Our results further demonstrated that transplantation analyses with GFP transgenic mice could be a useful approach to study the origin of cells in transplants.

The Journal of Medical Investigation : JMI


Flap Monitoring by Transcutaneous PO2 and PCO2:Importance of Transcutaneous PCO2 in Determining Follow-up Treatment for Compromised Free Flaps

The authors conducted a two-part study to determine whether transcutaneous oxygen pressure (TcPO (2)) and transcutaneous carbon dioxide pressure (TcPCO (2)) can be used to monitor flap viability after transplantation. The first part was an animal study in which TcPO (2) and TcPCO (2) were measured in 10 epigastric island flaps subjected to arterial or venous ischemia. The second part was a clinical study in which both were measured in 27 free skin flaps. In the experimental study, TcPO (2) decreased to nearly 0 mmHg after 10 minutes of arterial and venous ischemia. TcPCO (2) increased to 100 mmHg after 60 minutes of either type of ischemia. In the clinical study, congestion was suspected in six flaps on the basis of clinical signs alone. Three congested flaps with TcPCO (2) more than 90 mmHg were selected for intervention. The remaining three congested flaps, with TcPCO (2) 80 mmHg or less, survived completely without further treatment. The TcPO (2) of all treated flaps and of the six flaps not requiring further treatment was 0 mmHg. Results of experimental study indicate that TcPO (2) is more sensitive than TcPCO (2) to flap ischemia. However, results of clinical study suggest that it is very hard to distinguish congested flaps from healthy flaps by TcPO (2) alone. The authors believe that a congested flap with a TcPCO (2) more than 90 mmHg requires further treatment.


9.特殊部位の熱傷 会陰部・肛門部の熱傷

9.特殊部位の熱傷 会陰部・肛門部の熱傷

救急医学7 特集熱傷治療ガイド

救急医学7 特集熱傷治療ガイド


手背に発生した脂肪芽細胞腫の1例

手背に発生した脂肪芽細胞腫の1例


A case of subcutaneous ganglioneuroma: a case report and review of the literature

皮下に生じた神経節神経腫の1例


グラウンドのライン材が原因と考えられた化学破損の一例

グラウンドのライン材が原因と考えられた化学破損の一例


熱傷後に発症した急性ストレス障害の1例

熱傷後に発症した急性ストレス障害の1例


17．皮膚悪性腫瘍の診断と標準的治療法

17．皮膚悪性腫瘍の診断と標準的治療法


The Plastic Treatment for Cleft Lip and Cleft Palate

口唇裂・口蓋裂の形成外科的治療(The plastic treatment for cleft Lip and Cleft palate)

Journal of the Japanese Academy of Maxillofacial Prosthetics


Ⅲ四肢 2．損傷部位・形態からみた処置法 --- 1)指背・手背の切創，鋸創，刺創


創傷治癒と血管新生の基礎

創傷治癒と血管新生の基礎

Journal of Clinical and Experimental Medicine


特別講演「眼瞼部の形成外科的治療」

特別講演「眼瞼部の形成外科的治療」

第10回眼科医療フォーラム

第10回眼科医療フォーラム


トリーチャーコリンズ症候群に対する下顎骨延長の中期成績

トリーチャーコリンズ症候群に対する下顎骨延長の中期成績


臨床医学の展望2006-診断および治療上の進歩[4]形成外科学会

臨床医学の展望2006-診断および治療上の進歩[4]形成外科学会


レーザー治療最前線③ 3．太田母斑．異所性蒙古班．色素性母斑レーザー治療

レーザー治療最前線③ 3．太田母斑．異所性蒙古班．色素性母斑レーザー治療


Sarpogrelate hydrochloride an antagonist of 5-hydroxytryptamine receptor improves skin flap survival and suppresses thrombus formation in injured microvessels of rabbits.

The authors carried out two studies to examine the effects of the 5-hydroxytryptamine receptor antagonist, sarpogrelate hydrochloride (SH), on flap necrosis. The first study measured survival rates and included histologic examination of random-pattern skin flaps in rabbits. The second study assessed the time to complete obstruction of blood flow with the artificial thrombus formation method, and the time for leukocytes to adhere to the endothelium of microvessels in a rabbit-ear chamber. The treatment groups were injected with SH. The survival rates of skin flaps in the SH-treated group were increased significantly. Histologic examination of vessels in the control group revealed that vessels in the deep dermis were obstructed completely by thrombi, whereas such vessels were not obstructed in the SH-treated group. Thrombus formation time and leukocyte adhesion time in the SH-treated group were prolonged and decreased, respectively. Thus, SH maintained flap circulation and promoted flap survival by preventing thrombus formation.


手関節部に発生したびまん型関節外腱鞘巨細胞腫の1例

手関節部に発生したびまん型関節外腱鞘巨細胞腫の1例


耳下腺深葉を貫通した第一鰓裂由来瘻孔の1症例

耳下腺深葉を貫通した第一鰓裂由来瘻孔の1症例


皮膚微小血管障害の実験モデル

皮膚微小血管障害の実験モデル


痙性斜頚に対し，胸鎖乳突筋亜全摘術を施工した1例

痙性斜頚に対し，胸鎖乳突筋亜全摘術を施工した1例


レーザー治療最前線① 1.表在性血管腫(単純性血管腫，苺状血管腫)の色素レーザー治療


遊離皮膚移動術の実際(監修)

遊離皮膚移動術の実際(監修)


Involvement of Rab27 in antigen-induced histamine release from rat basophilic leukemia 2H3 cells

The Rab family small G proteins regulate discrete steps in vesicular transport pathways. Recent studies indicate that one member of the Rab family, Rab27A, regulates the transport of lysosome-related organelles, such as melanosome distribution in melanocytes, lytic granule release in cytotoxic T cells, and dense granule release in platelets. Here, we have examined the involvement of Rab27A in the exocytic transport of another lysosome-related organelle, the basophilic secretory granule, in basophils. We have found that Rab27A locates on basophilic secretory granules containing histamine in rat basophilic leukemia (RBL) 2H3 cells. In addition, exogenous expression of dominant active Rab27A reduces antigen-induced histamine release from the cells. We have moreover identified Munc13-4 as a Rab27A target using a CytoTrap system and found that exogenous expression of Munc13-4 affects antigen-induced histamine release from RBL-2H3 cells. These results demonstrate that Rab27A plays a crucial role in antigen-induced histamine release from RBL-2H3 cells.

Biochemical and Biophysical Research Communications


A soluble form of fibroblast growth factor receptor 2 (FGFR2) with S252W mutation acts as an efficient inhibitor for the enhanced osteoblastic differentiation caused by FGFR2 activation In Apert syndrome.


血管拡張性肉芽腫に対する硬化療法の工夫

血管拡張性肉芽腫に対する硬化療法の工夫

9歳，男児左小指指尖部に生じた欠陥拡張性肉芽腫に対してモノエタノールアミンオレイン酸溶液の局所注入が奏功した．この硬化療法は，従来の凍結療法が有用でない場合にも効果的であり，病変部への注入量を0.1ml以下にすることで副作用も起こりにくいと考えられる．血管拡張性肉芽腫に対して有用な保存的治療であると思われた．


血友病を合併した口蓋裂患者の治療経験

血友病を合併した口蓋裂患者の治療経験


Occlusal difficulties after simultaneous mandibular and maxillary distraction in an adult case of hemifacial microsomia.

A 23-year-old woman with hemifacial microsomia type IIB was treated by simultaneous mandibular and maxillary distraction. During the course of the distraction, cephalometric analysis showed that the maxilla was not moving downward and that the upper edge of the mandibular condyle was moving upward into the space between the condyle and the glenoid fossa. This phenomenon could lead to early consolidation of the osteotomized maxilla, resulting in malposition and occlusal difficulties. This is thought to be a problem unique to bimaxillary distraction of hemifacial microsomia type IIB with severe hypoplasia of the mandibular ramus and space between the condyle and the glenoid fossa. Surgeons should be alerted to this risk and prepared to address it when performing this procedure.


左前腕に発症した血管肉腫の長期生存例

左前腕に発症した血管肉腫の長期生存例

Journal of Japan Society of Plastic and Reconstructive Surgery


TEXT形成外科学 --- (著書分担)各論Ⅱ後天性疾患 Ⅰ外傷 4．身体各部の外傷 1)頭部外傷 2)顔面外傷


Skin Ulcer Caused by a General anesthesia Installing Agent:A case report

全身麻酔導入材によると考えられる皮膚潰瘍の1例


球肢を考えた皮弁·筋皮弁移植法

球肢を考えた皮弁·筋皮弁移植法

糖尿病や閉塞性動脈硬化症では下腿の血行が悪く，足部が動脈性壊死になったり，外傷や熱傷を受けると難治性漬瘍になりやすい．これらの患者では移植床の血行状態が悪いことが多く腱や骨が露出しやすいので，血行が温存されたままで移植可能な皮弁移植法の適応となる．有茎皮弁や遊離皮弁では下肢の既存の血管に侵襲がが及ぶことがあるので，血管造影を行い血行状態を把握したうえで，残存血管に影響の少ない術式を選択しなければならない．


Longitudinal evaluation of secondary bone grafting into the alveolar cleft

To longitudinally evaluate the outcome of secondary bone grafting (SBG) using computed tomograms (CTs) and conventional dental radiographs. Nineteen alveolar clefts from 17 patients were used in this study. A two-dimensional evaluation of SBG was performed using dental radiographs at 1 year after SBG by assigning scores of 1 to 4 (from very good to poor) based on postoperative marginal bone level on the alveolar side. On the basis of postoperative marginal bone levels on the nasal side, clefts were also assigned to groups with the bony bridge on or above (group I) or below (group II) a horizontal reference line. Three-dimensional evaluation of the SBG was performed on horizontal CT slices with the residual cortical bone (RCB) ratio before SBG (T0) as well as 1.5 (T1), 3 (T2), 6 (T3), and 12 months (T4) after SBG. The RCB ratio at T4 in the group with scores 1 and 2 was significantly smaller than that of score 3. Furthermore, the mean RCB ratio at T4 in group I was significantly smaller than that in group II. Nineteen alveolar clefts were divided into two groups, A and B, based on a cluster analysis of the RCB ratios. Group A showed a continuous decrease in the RCB ratio from T0 to T2, but group B showed a significant decrease only in the period from T0 to T1. These results suggested that the RCB ratio might be a useful parameter for evaluation of the bony bridge after SBG.


Intractable malleolar bursitis treated with lateral calcaneal artery adipofascial flap

Infections of the malleolar bursa, which is an adventitious bursa, rarely progress to intractable infectious bursitis. We present two cases of intractable malleolar bursitis. We performed successful transplantation of the lateral calcaneal artery adipofascial flap that resulted in healing of the bursitis. We discuss classification of bursae, treatments for bursitis and characteristics of the lateral calcaneal artery adipofascial flap.


Advances in distraction techniques for craniofacial surgery.

Distraction osteogenesis has been applied to the craniofacial skeleton as well as the long bones of the extremities. This technique does not require bone grafting and allows correction of craniofacial deformities with less invasion. Moreover, the distraction procedures can expand the overlying soft tissues simultaneously. We determined the indications of distraction osteogenesis, analyzed the types of devices available, and examined patients treated with distraction for the mandible, midface, and cranium. In all three sites, the devices tended to be the buried type and made of absorbable materials. Administration of some cytokines for shortening the consolidation period may be considered. Among disorders indicated for distraction osteogenesis, there are several syndromic craniosynostoses, which involve mutations in the fibroblast growth factor receptor (FGFR) 2 gene. The FGFR 2 mutation was suggested to clinically accelerate osteogenesis at the distraction site. The usefulness and appropriateness of the distraction protocol must be assessed for each individual disorder. Although distraction osteogenesis in the craniofacial skeleton has advanced technologically, all possible risks must be discussed with the patient and family members when obtaining preoperative informed consent, especially until establishment of fully safe distraction procedures.

The Journal of Medical Investigation : JMI


Malignant Melanoma of Soft Parts (Clear Cell Sarcoma) --- A Case Report

A subcutaneous tumor localized on the sole of the foot of a 25-year-old Japanese man was diagnosed as a malignant melanoma of the soft parts. We performed a wide local excision, elective lymph node dissection, and chemotherapy. Eight years after treatment, the patient is alive without local recurrence or metastasis.


Intracranial Hemorrhage Resulting From Skull Base Fracture As a Complication of Le Fort III Osteotomy

Various complications of Le Fort osteotomies have been reported. We describe a lethal complication of Le Fort III osteotomy we encountered in a 9-year-old boy with Crouzon syndrome. A standard Le Fort III osteotomy, including pterygomaxillary dysjunction with a curved osteotome and down-fracture manipulation, was performed uneventfully. When the intraoral buccal wound was closed after fixation of the external midface distraction devices, we discovered hemorrhage originating from the right posterior maxillary region. Although it was stopped with pressure on the osteotomized maxilla, the volume of intraoperative blood loss was nearly 2,000 ml. During the observation period in the intensive care unit, the patient suffered brain death, and he died 3 months later. A computed tomography scan obtained the day after surgery revealed vigorous subarachnoid and intraventricular hemorrhage and transverse fracture of the middle cranial fossa. This skull base fracture was believed to result from intraoperative maneuvers, including the pterygomaxillary dysjunction and down-fracture manipulation. We emphasize the risk of intracranial hemorrhage with Le Fort osteotomy and advise discussing this risk with patients and family members during preoperative consultations.


Sclerotherapy of Hemangioma with late involution

Most cutaneous hemangiomas involute spontaneously. However, the lesion existing on the face poses a cosmetic problem during the waiting period for involution. Hemangioma showing late involution was treated by local injection of monoethanolamine oleate solution. The lesion flattened and was excised serially. Sclerotherapy with monoethanolamine oleate can shorten the waiting period for involution and can decrease the risk of psychosocial trauma. Moreover, it provides good preparation for further surgery. Such sclerotherapy is effective in the treatment of hemangioma with late involution.


The features of thrombus in a microvessel injury model and the antithrombotic efficacy of heparin, urokinase, and prostaglandin E1.

In failed flap transfers and in burn injuries, superoxides and thrombi generated in the microcirculation are considered responsible for tissue injury. A dynamic and morphologic analysis of thrombus formation was conducted in a model of microvessel injury, and an analysis was made of the different antithrombotic effects of heparin, urokinase, and prostaglandin E(1). The dye-light method was used (i.e., injury of the endothelium by reactive oxygen species) to induce thrombus formation in both the arterioles and venules of the rabbit ear chamber under an intravital microscope-television system. The dynamic course of thrombus formation was observed, and the period from irradiation to complete obstruction of blood flow (i.e., time to stasis) was measured and compared in relation to various treatment conditions. Arteriolar thrombi were formed by platelet aggregation. Venular thrombi were composed of platelets and erythrocytes that gathered and adhered around leukocytes stuck to the vessel wall. Heparin treatment prolonged the time to stasis in both the arterioles and the venules. Urokinase extended the time to stasis in the venules but not in the arterioles. Prostaglandin E(1)-treatment significantly prolonged the time to stasis in the arterioles, but only high-dose prostaglandin E(1) prolonged the time to stasis in the venules. The results of this study show that endothelial damage caused by superoxides promotes the formation of thrombi that differ in composition between the arteriole and the venule and that the effectiveness of each drug varies accordingly. The authors believe that these agents can be used with increased efficacy if the two types of thrombi and the specific antithrombotic effects of each agent are considered.


Journal of Japan Society of Plastic and Reconstructive Surgery


Journal of the Japan Society of Cranio-Maxillo-Facial Surgery

日本頭蓋顎顔面外科学会誌


Midface Distraction in an Adult Patient with Crouzon Syndrome


Correction of a deformed thumb by distraction of the phalanx

We used distraction osteogenesis to correct six deformed thumbs in four patients ranging in age from 4 to 7 years. Two of the patients had Apert syndrome (syndromic craniosynostosis with symmetrical syndactyly) and two had polydactyly. We used a small fixator with a ball joint and successfully corrected the angular deformity after lengthening the proximal phalanx by distraction. This single inclusive procedure was extremely useful. We found the optimal distraction regimen for the digital phalanx was a one day waiting period and lengthening at 1 mm/day. The mean healing indexes were 37.2 days/cm (range 24.2 to 41.5) in those with Apert syndrome and 64.3 days/cm in those with polydactyly (62.5 and 66.0). Our results suggest that osteogenesis at the distraction site may be quicker in patients with Apert syndrome than in those with polydactyly.

Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery


Prognostic implications of nasal cavity and cleft morphology in secondary bone grafting

To examine the prognostic significance of the skeletal morphology around the nasal cavity and the alveolar cleft in secondary bone grafting (SBG). Fifty-one alveolar clefts in 41 patients (10 bilateral and 31 unilateral cleft lips and palates) registered in the Tokushima University Dental Hospital were examined in this study. Evaluation of the bony bridge after SBG using dental radiographs at 1 year after surgery. The clefts were divided into two groups: group I (54.9%) in which the upper border of the bony bridge was preferably maintained on or above the horizontal reference line (RL) constructed at the level of the root apex of the upper central incisor adjacent to the cleft, and group II (45.1%) in which the bone level was lower than the RL. Presurgical cleft width was determined by the dental radiographs. The cleft/nasal cavity ratio; the value of the cleft width divided by the nasal cavity width on the cleft side, which was analyzed by frontal cephalograms before the SBG; and the cleft/apertura piriformis ratio, the value analyzed by computed tomography, were used. The age, sex, and eruptive stage of the canine teeth at the time of the SBG showed no significant difference between groups. The presurgical cleft width also showed no significant difference between group I (6.6 +/- 3.1 mm) and group II (7.9 +/- 3.3 mm). The cleft/nasal cavity ratio showed a significant difference between groups I and II (0.42 +/- 0.14, 0.75 +/- 0.25; p < .05). Furthermore, the cleft/apertura piriformis ratio also showed a significant difference between groups I and II (0.32 +/- 0.12, 0.65 +/- 0.26; p < .05). These results suggested that measurements of the skeletal morphology around the nasal cavity and alveolar cleft might aid in predicting the stability of the bony bridge after SBG.


Segmental distraction of the midface in a patient with crouzon syndrome

We treated midface hypoplasia in a 20-year-old woman with Crouzon syndrome using a rigid external distraction device. The patient showed severe exophthalmos and maxillary retrusion, although relatively good occlusion had been achieved by long-term orthodontic procedures. We considered that our patient's particular condition could not be resolved by the usual Le Fort III osteotomy/midface distraction procedure, so we devised a segmental approach. The midface, mobilized by Le Fort III osteotomy, was divided into two segments by Le Fort I osteotomy; each fragment was connected to the rigid external distraction device to be distracted separately. Distraction was begun after 1 day at 1 mm/day. The upper and lower segments were distracted over 17 and 12 days, respectively. The patient's occlusion was fully corrected, and her facial contour was significantly improved. After 3 weeks of consolidation, we removed the distraction device. The clinical course was without complication, and no relapse was observed on the cephalogram or computed tomography scan obtained 1 year after the procedure. Our modified technique was helpful in increasing the usefulness of the external distraction system and in refining the midface distraction procedure.


前額部の皮下腫瘍摘出術における頭髪生え際切除法 --- 局所解剖所見からの工夫

前額部の皮下腫瘍摘出術における頭髪生え際切除法 --- 局所解剖所見からの工夫

日本頭蓋顎顔面外科学会誌


The Gluteal-Fold Flap for Vulvar and Buttock Reconstruction --- Anatomic Study and Adjustment of Flap Volume

The ideal skin-flap reconstruction provides functional preservation and a good cosmetic outcome in both the reconstructed site and the donor site. Although various flaps are used for reconstruction of the vulvar and buttock region, there are disadvantages associated with each. In 1996, Yii and Niranjan reported the gluteal-fold flap for vulvar reconstruction. As presently used, this flap is bulky, particularly in obese patients or when used for hemilateral reconstruction. Thinning the flap has been considered impossible because of the obscurity of the blood supply. In the study presented here, the pedicle vessels of this flap were studied in eight cadavers; the authors found that the flap is nourished by a direct cutaneous system of the internal pudendal artery and vein. Accordingly, adjustment of the flap volume was believed to be possible, with the exception of the adipose tissue containing the pedicle vessels. The authors have since used 14 thinned flaps for seven vulvar, one vaginal, and two buttock defects in 10 patients. All flaps survived completely. Good functional and cosmetic results were achieved with hemilateral or bilateral flaps in vulvar or buttock reconstruction. In the buttock in particular, the usefulness of this flap for anal and pelvic-floor reconstruction was demonstrated. The scar at the donor site, concealed in the gluteal fold, was acceptable. The gluteal-fold flap is very useful for various vulvar and buttock reconstructions because it can be adjusted to the required volume.


transcutaneous PO and PCO Monitoring for Flap Transplanted in Microsergery


色素性母斑に対する治療法の選択

色素性母斑に対する治療法の選択


Treatment of Pyogenic Granuloma with a Sclerosing Agent


First Cutaneous Branch of the Internal Pudendal Artery --- An Anatomical Basis for the So-called Gluteal Fold Flap

We investigated the cutaneous blood supply in the gluteal and perineal regions of 35 donated cadavers to provide an anatomical basis for reliable vulvo-vaginal reconstruction using a skin flap such as the so-called gluteal fold flap. The cutaneous areas along the gluteal cleft and sulcus were likely to be supplied by 3 routes: 1) the internal pudendal artery (IPA), especially its first cutaneous branch; 2) perforators running through the gluteus maximus muscle and arising from the inferior gluteal artery (IGA); and 3) a non-perforator running around and inferior to the ischial tuberosity and originating from the IGA. Route 1 supplied the skin along the gluteal cleft, route 2 the gluteal fold (i.e., a bulky skin fold along the upper edge of the gluteal sulcus), and route 3, just along the gluteal sulcus. In those 3 routes, we noted the consistent morphology of the thick and long, first cutaneous branch of the IPA. The first arterial branch, 1.5 mm in diameter at its origin on average (ranging from 0.7-2.6 mm), usually originated from the IPA under the cover of or at the inferomedial or distal side of the sacrotuberous ligament (almost always less than 20 mm from the inferomedial margin of the ligament). The branch ran superomedially toward the coccyx or ran medially in the ischiorectal fat. It accompanied the vein and nerve at its distal (peripheral) course although the nerve often ran independently at its proxomal course near the ligament. Therefore, the first branch of the IPA seems to provide a reliable pedicle using the skin along the gluteal cleft whether the incision for approach is conducted along the gluteal sulcus or not. However, if the gluteus maximus muscle extended much inferomedially, the pedicle would be very short. In this case, preparation of the pedicle seems to be necessary along the arterial course under the cover of the muscle.


循環不全を血栓溶解療法で治療した遊離筋皮弁の1例

循環不全を血栓溶解療法で治療した遊離筋皮弁の1例

日本マイクロサージャリー学会会誌

日本マイクロサージャリー学会会誌


褥瘡治療にティッシュ·エキスパンダーを使用した1例

褥瘡治療にティッシュ·エキスパンダーを使用した1例


Endoscopic Harvest of Pectoralis Major Muscle Flap for Correction of a Neck Deformity


Acceleration of in vitro mineralization of osteoblast-like cells derived from Apert syndrome patients

22nd annual meeting of the American society for bone and mineral research


糖尿病における皮膚微小血管障害―Rabbit Ear Chamber法を用いた肉眼的観察―


A clinical comparison of scar qualities using PDS II and nylon subcuticular sutures

合成吸収性縫合糸polydioxanone(PDS11)とナイロン糸の鼠径部採皮創における術後瘢痕の比較検討


The effects of desferrioxamine on thrombus formation in injured microvesseles of rabbit ear

We investigated the effects of the iron chelator desferrioxamine (DFX) on thrombus formation in the arterioles and venules of the rabbit ear chamber. Thrombi were induced by irradiation with filtered light in combination with a fluorescent dye. The occlusive thrombus formation time was significantly extended by DFX. The morphological composition of thrombi in the arterioles and venules was different. In the arterioles, the thrombi consisted of platelet aggregation, but in the venules, platelets and leukocytes accumulated on the endothelium. This suggest that hydroxyl radicals may be important mediators in this model, as DFX is known as a hydroxyl radical scavenger. Furthermore, the components of thrombi in the arterioles and venules in the skin microvascular system may be different.

The Journal of Medical Investigation : JMI


Reconstruction of The Sacral Region Using a Gluteal Perforator-based Flap

殿部穿通枝皮弁を用いた仙骨部病変の再建について

小松島赤十字病院医学雑誌

小松島赤十字病院医学雑誌


Vulvo-vaginal Reconstruction with Gluteal Fold Flaps


遊離植皮成功のコツと植皮部・採皮部の術後ケア

遊離植皮成功のコツと植皮部・採皮部の術後ケア


Lower eyelid reconstruction with a cheek flap supported by fascia lata.


Cerebriform intradermal nevus:A case of scalp expansion on the galea.


Cerebriform Intradermal Nevus --- A Case of Scalp Expansion on the Gales


The Morphological Evaluation of a Case with Crouzon's Disease before and after Le Fort III Osteotomy

Le FortⅢ型骨切り術を施行したcrouzon病患者の術前術後の顎態評価

Crouzon's disease is one of the most common craniofacial syndromes that occur due to premature closure of cranial sutures. It is characterized by craniosynostosis, calvarial deformity, maxillary hypoplasia resulting in relative mandibular prognathism, hypertelorism, and exophthalmos. In this paper, the clinical findings and the treatment process of a twelveyear-old male patient with Crouzon's disease who underwent surgical orthodontic treatment before adolescence were reported.
1. This patient presented hypertelorism, disturbance of eyelid closing dueto exophthalomos, and skeletal class III malocclusion caused by growth retardation of the maxilla.
2. Frontal advancement was performed in order to cure the neurological symptons whilethe preoperative orthodontic treatment was underway.
3. Le Fort III osteotomy was performed by moving the mid-face in the forwardand downward direction, as well as by rotating it clockwisely. The mandible also rotated clockwisely as a result of the displacement of the mid-face. The soft tissue profile and occlusion was markedly improved in this case.
4. Immediatelyafter surgery, upward maxillary movement was observed. The condylar position in the fossa looked more favorable by roentgenographic observation after one year and seven months of treatment than that at the initial stage.


The morphological evaluation of a case with Crouzon's disease before and after Le Fort III osteotomy

Le Fort III 型骨切り術を施行したCrouzon病患者の術前術後の顎態評価


The Effect and Clinical Course of Laser Treatment for Hemangioma Simplex : Using a chromameter

単純血管腫のレーザー治療の効果予測と治療経過の定量 ―色彩計を用いて―


脛骨骨膜から発生したと思われる骨膜下ガングリオンの1例

脛骨骨膜から発生したと思われる骨膜下ガングリオンの1例


幼児の眼窩内木片異物の1例

幼児の眼窩内木片異物の1例


Argatreban Ozagel Naの家兎耳介皮膚微小循環における抗血栓効果

日本マイクロサージャリー学会会誌

日本マイクロサージャリー学会会誌


「基礎研究」皮膚潰瘍における血管内皮細胞の働き

「基礎研究」皮膚潰瘍における血管内皮細胞の働き

メディカルビューポイント

メディカルビューポイント


東洋人のApert症候群患者におけるFibroblastgrowth factor receptor 2遺伝子の変異―2症例の検討―


Mutation of the fibrobrast growth factor receptor2 gene in Japanese patients with Apert syndrome


Color analysis of nevus of Ota for evaluation of treatment with a Qswiched alexandrite laser.


胸鎖関節部に発生したDermoid Cystの1例

胸鎖関節部に発生したDermoid Cystの1例


外傷と形成外科 ―労働災害を中心に― Plastic surgical treatment of facial injuries and burns


単純性血管腫上に生じた基底細胞癌

単純性血管腫上に生じた基底細胞癌


太田母斑のQスイッチアレキサンドライトレーザ―治療

太田母斑のQスイッチアレキサンドライトレーザ―治療


広範囲皮膚潰瘍の植皮術にリドカインクリームを使用した1例

広範囲皮膚潰瘍の植皮術にリドカインクリームを使用した1例


Journal of the Japan Society of Cranio-Maxillo-Facial Surgery

日本頭蓋顎顔面外科学会誌


精神分裂病患者に発症したBuffalo humpの1例

精神分裂病患者に発症したBuffalo humpの1例


Qスイッチアレキサンドライトレーザーを用いた外傷性刺青の治療経験

Qスイッチアレキサンドライトレーザーを用いた外傷性刺青の治療経験


カラーアトラス―爪床の有棘細胞癌―

カラーアトラス―爪床の有棘細胞癌―


Effect of Prostaglandin E1 on Cutaneous Microcirculation of Flap or Replantation.


Linear porokeratosis with multiple squamous cell carcinomas Study of p53 expression in porokeratosis and squamous cell carcinoma


Ultrastructural heterogeneity of acquired intradermal melanocytic nevus cells

The present ultrastructural evaluation of 12 acquired intradermal melanocytic nevi revealed that in contrast to the nested epithelioid melanocytic nevus cells of the upper dermis, the spindle nevus cells of the deep dermis showed perineurial differentiation, exhibiting a spindly configuration characterized by a melanosome-free cytoplasm that showed extremely slender bipolar contour and contained abundant intermediate filaments, a decreased number of cytoplasmic organelles, and, significantly, a fair number of plasmalemmal pinocytotic vesicles. The nevic corpuscles were found to consist of laminated slender cytoplasm showing subcellular conformation similar to that of the spindle nevus cells. By immunohistochemistry, many spindle nevus cells and nevic corpuscles were immunoreactive for nerve growth factor receptor. All the nevus cells were immunoreactive for vimentin and S-100 protein, and negative for protein gene product 9.5, epithelial membrane antigen, Leu-7, and myelin basic protein. Characteristically, protein gene product 9.5 immunohistochemistry revealed numerous immunoreactive axons intermingled with the spindle nevus cells in the deep portion. All the PGP9.5-immunoreactive axons were observed by immunoelectron microscope to be unmyelinated and always ensheathed by a thin cytoplasmic process of Schwann cells but not nevus cells. These findings indicate that differentiation plasticity exists in the various nevus cells, with the epithelioid nevus cells and the spindle nevus cells displaying more ultrastructural and immunophenotypical characteristics of melanocyte and perineurial cells, respectively, suggesting that a pluripotential cell of neural crest origin accounts for the histogenesis of this lesion.


骨外性粘液型軟骨肉腫に対する遊離植皮術後に発症した肺塞栓の1例

骨外性粘液型軟骨肉腫に対する遊離植皮術後に発症した肺塞栓の1例


悪性リンパ腫を合併した基底細胞癌の2例

悪性リンパ腫を合併した基底細胞癌の2例


3世代にわたって発症した軸前性多合趾症の1例

3世代にわたって発症した軸前性多合趾症の1例


肥厚性瘢痕・瘢痕拘縮の観血的治療

肥厚性瘢痕・瘢痕拘縮の観血的治療


7%リドカインクリームと60%リドカインテープの効果比較―リドカインクリームの採皮における使用経験も含めて―


皮膚表面画像の色解析による太田母斑のレーザー治療の効果判定について

皮膚表面画像の色解析による太田母斑のレーザー治療の効果判定について

Qスイッチアレキサンドライトレーザー治療による太田母斑部皮膚色の変化をビデオマイクロスコープとコンピューターを用いて解析した．10人の患者の治療前，治療後の母斑部と対照部の画像を採取し，画像解析により3種の表色系で両部の色の差異(■)を計測した．その結果，明るさを示す指標である■L*(L*a*b*系)，■メラニン指数(紅斑・メラニン指数系)，■明度(マンセル系)が照射前後で有意に変動し(p<0.01)，臨床的印象・評価と並行した．従って太田母斑のレーザー治療効果を色測定で定量する場合，明るさを表す指標が最も有用であり，客観的・定量的な効果判定に応用しうるものと考えた．


Serial Cultivation of Human Nail Matrix Cells under Serum-free Conditions

We have established serial cultures of human nail matrix cells (NMCs) under serum-free conditions. We cultured NMCs using two different methods depending upon the volume of nail matrix obtained. When a sufficient amount of nail matrix was obtained, they were minced and treated with 0.25% trypsin and 0.03% EDTA. The NMCs were transferred directly as a dispersed cell culture into KGM medium. Because a sufficient amount of matrix was rarely obtained, we developed a method by which NMCs were cultured primarily as implanted small matrices in Eagle's MEM (high Ca+ medium) supplemented with 15% fetal bovine serum for the first 4 to 5 days; during this time, the NMCs expanded from the matrices and formed colonies around them. NMCs then were cultured with KGM. In both methods, KGM medium supported the growth of NMCs without a biological feeder layer. These cells could be cultivated serially for at least seven passages. Half of the cells were positively stained with a monoclonal antibody against hair (hard) keratin which is expressed in nail matrix in vivo, indicating that the cells originated from the nail matrix. These methods will now permit investigations of nail matrix cells that previously were unfeasible because of the relative lack of cells and difficulties with propagation.


Striated Muscle Hamartoma of the Nostril


Frequent p53 Accumulation in the Chronically Sun-Exposed Epidermis and Clonal Expansion of p53 Mutant Cells in the Epidermis Adjacent to Basal Cell Carcinoma.

The Journal of Investigative Dermatology


被虐待児症候群にみられた重症熱傷の2例

被虐待児症候群にみられた重症熱傷の2例


Malignant Melanoma Developing in an Area of Palmoplantar Keratoderma (Greithers Disease)


Effect of deferoxamine on thrombusm formation in a Rabbit Ear Chamber of an ischemic flap

Scientific papers of x I th international conferderation for Plastic Surgery


Tissue expanderと広背筋皮弁による乳房再建術の経験

Tissue expanderと広背筋皮弁による乳房再建術の経験


SNK-863軟膏の採皮創に対する臨床評価 ―少数例の採皮創を対象とした至適用量(濃度)の予備的検索―


皮膚潰瘍に対するSNK-863軟膏の臨床的有用性 ―リフラップ®軟膏を対照とした電話割付法による群間比較試験―

The Japanese journal of clinical and experimental medicine


第1鰓裂由来の瘻孔および嚢腫の3例

第1鰓裂由来の瘻孔および嚢腫の3例


皮膚潰瘍に対するSNK-863軟膏の臨床評価

皮膚潰瘍に対するSNK-863軟膏の臨床評価

Japanese Journal of Medicine and Pharmaceutical Science


皮膚科に必要な形成外科的手技

皮膚科に必要な形成外科的手技

西部支部企画前実績研修講習会テキスト

西部支部企画前実績研修講習会テキスト


ラビットイアーチャンバーを用いた血管新生観察法

ラビットイアーチャンバーを用いた血管新生観察法


小範囲熱傷に対するアロアスクDⓇとバラマイシンⓇ軟膏との臨床効果の比較

小範囲熱傷に対するアロアスクDⓇとバラマイシンⓇ軟膏との臨床効果の比較


Hemopneumothorax secondary to multiple cavitary metastasis in angiosarcoma of the scalp

We report a case of hemopneumothorax secondary to multiple cavitary metastasis in the angiosarcoma of the scalp in an 86-year-old woman, who died of respiratory failure. At autopsy, multiple cavities were found in both lungs. Histologic specimen of the cavitary metastasis of the lung showed that tumor cells proliferated forming several tubular spaces and these tubular spaces seemed to communicate with the central cyst. These findings suggested that imperfect vessel-like structures of the cavitary metastasis are likely to break down and finally grow up to large thin-walled cavities.


Dispersed Cell Culture of Human Sweat Duct Cells under Serum-free Conditions

Human eccrine gland duct cells were successfully cultured using a serum-free medium, K-GM medium. Eccrine sweat ducts were isolated from dispase treated skin specimens from palms or soles. After treatment of the isolated ducts with trypsin and EDTA, dispersed cells were cultured in K-GM medium. In primary cultures, small colonies were seen 3 to 4 days after inoculation. Then the cells rapidly proliferated and formed large colonies with a paving stone-like cell arrangement. During the culture, small dome shaped areas were sometimes formed in the centers of colonies. Cultures multiplied for a maximum of 7 passages. The plating efficiencies of the 1st to 6th passage cells were about 20% to 30%. Immunocytochemically, cultured cells were positively stained with anti-carcinoembryonic antigens, K8.37 and K8.13, but not with anti-S100 protein, anti-HLA-DR, 34 beta B4, or PKK3. An electron micrograph of the cultured cells showed a multilayer of flattened cells linked by desmosomes. These results indicate that the cultured cells possessed the staining properties compatible with those of the ductal portion of eccrine sweat glands. No contamination by other mesenchymal cells, such as fibroblasts, was seen during the culture.


先天性外鼻軟骨欠損を伴ったBinder症候群の1例

先天性外鼻軟骨欠損を伴ったBinder症候群の1例


Solitary Infantile Myofibromatosis of Bone An Immunohistochemical and Ultrastructural Study

A rare case of solitary infantile myofibromatosis of bone in an 11-month-old boy is reported. Radiographically the lesion of parietal bone was round, well-circumscribed, and osteolytic with a sclerotic rim. Histologically the tumor was made up of nodules that were hyalinized or cellular and containing plump, spindle-shaped cells that were intermediate in appearance between fibroblasts and smooth-muscle cells, arranged in short bundles or whorls. Another typical feature was the presence of distended, cleft-shaped vascular spaces around the nodules. The microscopic features of this tumor were consistent with those of infantile myofibromatosis of other sites, such as the skin and deep soft tissue. The tumor cells showed immunoreactivities for vimentin and alpha-smooth muscle actin. Microfilaments with dense bodies were observed in the fibroblast-like tumor cells. In addition, many tumor cells stained for collagen type IV and were covered by incomplete external laminae, indicating infantile myofibromatosis has more advanced smooth-muscle differentiation than conventional fibromatosis.

The American Journal of Surgical Pathology


Microcystic Adnexal Carcinoma Case Report with an Immunohistochemical Study

We report the case of 71-year-old Japanese woman with microcystic adnexal carcinoma (MAC) of the nose. Our histological and immunohistochemical observations suggest that MAC has both pilar and eccrine sweat gland differentiation.


輪ゴムによる頚部仮性絞扼症の1例

輪ゴムによる頚部仮性絞扼症の1例


皮膚科領域感染症に対するS-1108の臨床的検討

皮膚科領域感染症に対するS-1108の臨床的検討


下腿潰瘍と深部血栓性静脈炎，肺血流低下を伴ったベーチェット病

下腿潰瘍と深部血栓性静脈炎，肺血流低下を伴ったベーチェット病


シクロスポリンが奏効した尋常性天疱瘡の1例

シクロスポリンが奏効した尋常性天疱瘡の1例


Light Microscopic Autoradiographical Analysis of [125] Epidermal Growth Factor Binding in Basal Call Epithelioma and Squamous Cell Carcinoma of the Skin


Juvenile gigantomastia: report of a case


Immunohistological analysis of P53 expression in human skin tumors

The p53 expression in various skin tumors was immunohistologically evaluated using two mouse monoclonal anti-p53 antibodies, PAb421 and PAb1801. The p53 expression was not detected in the normal epidermal cells. Nuclear staining suggested that the p53 expression was observed in 10 of 26 squamous cell carcinomas (SCCs) from 24 patients, in one undifferentiated carcinoma, one proliferating trichilemmal cyst, one malignant proliferating trichilemmal tumor and in one metastatic carcinoma of breast cancer. None off four cases of Bowen's disease (SCC in situ) showed nuclear staining. In the SCCs, five of 20 primary lesions, three of four recurrent lesions and both of two metastatic lesions had positive nuclei. There was one case of SCC in which a primary lesion was negative but a recurrent lesion was positive. Thus, p53 expression was more frequently observed in SCCs at more clinically advanced stages. This may suggest that p53 has some relevance to progression of SCC. Nuclear staining was not detected in any of the following cases: two cases of seborrheic keratosis, one eccrine poroma, one keratoacanthoma, 11 basal cell epitheliomas, two mammary Paget's disease, three genital Paget's disease, one sebaceous carcinoma, four malignant melanomas, six lymphomas, two leukemia cutis and two angiosarcomas.


プロスタグランジンE1の皮膚微小循環に及ぼす影響―生体顕微鏡法による検討―

プロスタグランジンE1の皮膚微小循環に及ぼす影響―生体顕微鏡法による検討―


遊離広背筋皮弁移植部に習慣性丹毒をきたした1例

遊離広背筋皮弁移植部に習慣性丹毒をきたした1例

日本マイクロサージャリー学会誌

日本マイクロサージャリー学会誌


培養ヒト成長期毛包および外毛根鞘細胞に対するMinoxidil Sulfateの影響


MYOCUTANEOUS FLAPS FOR COVERAGE OF SKIN DEFECTS AFTER RADICAL SURGERY FOR ADVANCED PENILE CARCINOMA


皮膚科領域におけるグランダキシン○Rの臨床的検討

皮膚科領域におけるグランダキシン○Rの臨床的検討


家族内発生をみた石灰化上皮種

家族内発生をみた石灰化上皮種


VASODILATORY EFFECTS OF PROSTAGLANDIN E1(PGE1)ON MICROCIRCULATION OBSERVED IN THE RABBIT EAR CHAMBER

International confederation for plastic and reconstructive surgery


The influence of cutaneous factors on the transcutaneous PO2 and PCO2 at various body sites

The transcutaneous partial pressures of oxygen (tcpO2) and carbon dioxide (tcpCO2) were measured at eight different sites in 10 adult male subjects with an electrode at a temperature of 44 degrees C. The mean tcpO2 values (mmHg) were significantly lower on the face (forehead 26.6, cheek 29.6) and the palm (26.4) than at other sites (60.6-69.6). The tcpCO2 values (mmHg) were only slightly higher on the face. Removal of the stratum corneum produced an average increase of the tcpO2 on the palm of 37.6 mmHg and on the forehead of 19.6 mmHg. However, in 10 children with an age range of 3-9 years, the difference in the mean pO2 between the cheek and forearm was very small. There was no significant difference in the cutaneous blood flow at 44 degrees C between the cheek, palm and forearm.


The effect of 1, 25-dihydroxyvitamin D3 on the growth and differentiation of cultured human outer root sheath cells from normal subjects and patients with Vitamin D-dependent rickets type with alopecia

We examined the effect of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) on the growth and differentiation of cultured human hair outer root sheath cells (ORSC) from normal subjects and patients with vitamin D-dependent rickets type II (DDR-II) with alopecia. 1,25(OH)2D3 dose-dependently suppressed the plating efficiency, clonal growth, and DNA synthesis of normal ORSC. It enhanced the cornified envelope formation and caused morphological changes in the cells. All results indicated the existence of specific receptors for 1,25(OH)2D3 in the ORSC, and suggest that 1,25(OH)2D3 is a potent inhibitor of proliferation of ORSC as well as a stimulator of terminal differentiation. However, the cells from DDR-II patients with alopecia did not respond to 1,25(OH)2D3, suggesting a lack of the specific receptors in the cells. The differences in the cellular response to the hormone between the normal ORSC and those from the patients were apparent and easily distinguishable, therefore this experiment may be a rapid and simple diagnostic test for DDR-II patients with alopecia. Large number of hairs were difficult to obtain from patients with alopecia, and we developed a new culture method to accomplish these studies from a few plucked hair follicles. Our system may be useful in the culture of ORSC from limited number of follicles, and could be utilized to analyse the cellular characteristics of ORSC in patients with hair diseases.


Transcutaneous PO2 and PCO2 Measurements in Various Skin Lesions

Low tcPO2 levels were observed in various skin lesions, indicating that most pathological changes in the skin induce such a reduction. In contrast, the tcPCO2 changed less, with the exception of marked elevations in bullous or prenecrotic lesions. This procedure may have practical applications in clinical dermatology, particularly in quantitating the response to therapy and in predicting a necrotic change.


Culture of human outer root sheath cells from plucked hair follicles in serum-free conditions

We succeeded in culturing human outer root sheath cells (ORSC) in serum-free conditions without a biological feeder layer. The combination of collagen type IV substrate and modified MCDB 153 medium supplemented with bovine pituitary gland extract (K-GM medium) could support the growth of ORSC. These cells can be serially cultivated for at least 4 passages and stored in liquid nitrogen with good recovery. Thus, a large series of experiments using ORSC may be run simultaneously.


手術により得た爪母より，explant culture，dispersed cell culture，およびゲル内での三次元的なexplant cultureの3方法でヒト爪母細胞を培養した．Explant cultureではⅣ型コラーゲンをコートしたシャーレ上でも無処理シャレー上でも初期には細胞は同様に増殖したが，無処理シャーレでは細胞が早期より角化(細胞の大型化と脱核)した．Dispersed cell cultureではⅣ型コラーゲンをコートしたシャーレとⅣ型コラーゲンをコートしたⅠ型コラーゲン膜上でともに細胞は増殖したが，plating efficiencyは前者では約0.2%，後者では約0.5%であった．また前者では角化が早く始った．無処理シャーレ上でも細胞は接着したが増殖しなかった．培養経過中にコロニー内で細胞が積み重なり，程度の差はあれ，ドーム状に盛り上る現象が，explant culture，dispersed cell cultureでみられた．コラーゲンゲル内での三次元的なexplant cultureでは全方向に向かって細胞が出現し，樹枝状に増殖した．電顕所見ではケラトヒアリン顆粒はみられず，コラーゲン膜と細胞間に基底模様構造もみられなかった．培養細胞の抗毛ケラチンモノクローナル抗体を含む各種抗ケラチン抗体に対する反応は，組織爪母細胞と同様で，表皮基底細胞，表皮有棘細胞，培養表皮細胞のいずれとも異っていた．爪母細胞は表皮細胞や外毛根鞘細胞とほぼ同じ条件でよく増殖し，表皮細胞とは異った性質を有することがわかった．


溶媒保存処理大腿筋膜移植の経験

溶媒保存処理大腿筋膜移植の経験

Journal of Japan Society of Plastic and Reconstructive Surgery


クレゾールによる自傷性皮膚腫瘍を呈したMünchausen症候群の1例

クレゾールによる自傷性皮膚腫瘍を呈したMünchausen症候群の1例


唇・顎裂を合併した高度短合指症例の経験

唇・顎裂を合併した高度短合指症例の経験


Treacher collins症候群の治療経験 ―側頭筋頭蓋骨移植―

Treacher collins症候群の治療経験 ―側頭筋頭蓋骨移植―


Malignant proliferating trichilemmal tumorの2例


卵黄腸管(臍腸管)遺残の2例 ―臍形成について―

卵黄腸管(臍腸管)遺残の2例 ―臍形成について―


Evaluation of tissue expansion using laser doppler flowmeter and transcutaneous PO2 PCO2 moniters


Japanese Journal of Clinical Dermatology


Eosinophilic Polymyositis Induced by Tranilast

A 38-year-old man with asthma developed eosinophilic polymyositis following the administration of Tranilast, an antiasthmatic agent. Low grade fever, erythematous rashes on the entire body, dysphagia, blood eosinophilia, elevations of serum creatine phosphokinase and myoglobin levels, and inverted T waves in the electrocardiogram were noted. A muscle biopsy showed focal degeneration of muscle fibers with an infiltrate of eosinophils and lymphocytes. A rechallenge with Tranilast resulted in erythema formation, blood eosinophilia, and elevations of some serum muscle enzymes and myoglobin levels. Tranilast was considered to be the causative agent. This is the first reported case of Tranilast-induced eosinophilic polymyositis.


生体顕微鏡法による微小循環の観察 ―コルチコステロイドの血管新生におよぼす影響について―


ヒト抜去毛包のコラーゲンゲル内培養

ヒト抜去毛包のコラーゲンゲル内培養

肉眼的に外毛根鞘を付着するヒト抜去毛包をⅠ型コラーゲンゲル内で培養した．培養3∼4日目より毛包が肥大し，また外毛根鞘部よりゲル内に上皮系の細胞も出現し，以後4週間にわたり突起を形成しながら3次元に増殖した．毛球部を取り除いた細切毛包の培養でも同様の細胞増殖がみられた事より，増殖した上皮細胞は外毛根鞘由来と考えた．突起の数，径，性状は個々の毛包で異なっていた．肥大毛包部では最外層にDNA合成細胞が局在し，突起部でも外側縁にDNA合成細胞がみられた．本実験系は各種条件下での外毛根鞘細胞の3次元増殖を観察するのに適した系と思われる．また外毛根鞘細胞と他器官の細胞との相互作用の探究にも役立つであろう．


外傷後に生じた鼻部囊腫の1例

外傷後に生じた鼻部囊腫の1例


術後性上顎骨嚢胞が疑われた1例

A 33-year-old man, who had received an operation for paranasal sinusitis at the age 16, developed an asymptomatic mass in the right cheek. Our examination showed a cyst destroying the maxillary bone. The cyst was surgically removed and ultimately considered to be a postoperative maxillary cyst. The resulting defect in the maxillary bone was filled with iliac bone chips with satisfactory results. Though most cases of such cysts tend to occur under the supraorbital nerve and vessels, this case was found to overlie them. We reviewed previously reported cases and briefly discussed the cause, differential diagnosis, and treatment of this disorder.

術後16年を経て出現した術後性上顎骨嚢胞と思われる症例を, 腸骨を用いて再建し, 再発も無く整容的にも満足しえたので報告した．また本例も含め, 上顎骨周囲に発生する疾患について若干の文献的考察を加えた．


"てこずった"老年者の感染症 ―皮膚科における―

"てこずった"老年者の感染症 ―皮膚科における―


ビタミンD依存性クル病Ⅱ型患者毛包細胞に及ぼす1，25-dihydroxyvitamin D3の影響


血管系症状を伴ったベーチェット病の2例

血管系症状を伴ったベーチェット病の2例


Liquid-holding recovery of sister chromatid exchanges in UV-irradiated normal and xeroderma pigmentosum complementation groups A and F fibroblasts.


CULTURE OF DISPERSED HAIR FOLLICLE CELLS FROM PLUCKED OUT HAIRS WITHOUT A FEEDER LAYER

Dispersed hair follicle cells from plucked out hairs have been successfully grown on collagen type IV without a biological feeder layer. The optimal calcium concentration for the culture of these cells was also studied and decided to be 0.3-0.5 mM. In this calcium range and on collagen type IV, colony formation and colony growth were best and big colonies with a paving stone-like cell arrangement were formed. The availability of such cultured cells for the treatment of missing skin is proposed instead of cultured epidermal keratinocytes which have been commonly used for wound dressing.

The Tokushima Journal of Experimental Medicine


Studies on the microcirculation in the rabbit ear chamber with a vital microscope. The process of new growth of vessels.:-The Process of New Growth of Vessels-

生体顕微鏡法による微小循環の観察 ―創傷治癒過程における血管新生過程の観察を中心に―

Since angiogenesis is an important process of wound healing, the entire process of the new growth of vessels was microscopically investigated using a rabbit ear chamber. After installation of a transparent chamber on the ear, new capillary sprouts arose from the surrounding blood vessels on the edge of the table in 5 to 7 days. There were two types of sprouts. One was tapered and the other was saccular. After about 2 weeks, the sprouts formed capillary loops by fusion and new sprouts were produced from the loops. During the process, some capillaries were differentiated into arterioles and venules, while some remained as capillaries, and still others retracted and disappeared. The average time for complete vascularization of the table area was between 3 to 4 weeks after operation and then it was possible to clearly observe microcirculation in the capillary networks on the transparent chambers through a vital microscope over a period of several weeks. This technique can be a powerful tool for better understanding the process of wound healing.

血管新生(agiogenesis)は, 創傷治癒過程に重要な役割を果たす．われわれは, 創傷治癒過程を追究する一環として, ウサギ耳介にチャンバーを装着後, 微小循環網が完成するまでの過程を経時的に観察し, 浸出期, 血管芽期, 血管増殖期と完成期の4期に分けえることを報告した．


痔瘻と交通した臀部慢性膿皮症の1例

痔瘻と交通した臀部慢性膿皮症の1例


耳介部ケロイドの治療経験

耳介部ケロイドの治療経験


円形脱毛症における毛球部浸潤リンパ球の免疫組識化学的解析

円形脱毛症における毛球部浸潤リンパ球の免疫組識化学的解析


Follicular atrophoderma with multiple basal cell carcinomas. An abortive form of bazex syndrome.:-An Abortive Form of Bazex Syndrome-

Follicular Atrophodermaを持つ中年男子にみられた多発性基底細胞癌 ―Bazex症候群の不完全型か―

Multiple basal cell carcinomas developed predominantly on the sun exposed areas in a 52-year-old Japanese man. He also had follicular atrophoderma on the extensor aspect of the extremities. Five other siblings were free from symptoms, but his mother suffered from follicular atrophoderma. These findings were consistent with the syndrome described by Bazex et al. However, because the patient lacked other cardinal skin synptoms such as abnormalities of scalp hair and sweating, a diagnosis of an abortive form of Bazex syndrome was made. Numerous basal cell carcinomas were also observed on the trunk, a non-exposed area, previously irradiated with X-rays. We would like to emphasize that radiation therapy should be avoided in patients with Bazex syndrome. Here we report the first case of this rare inherited syndrome in Japan.

四肢伸側に毛孔性皮膚萎縮を持つ中年男子に基底細胞癌が多発した．他の5人兄弟には皮疹をみなかつたが, 母親にも同様の毛孔性皮膚萎縮をみたことよりBazex症候群が疑われた．毛孔性皮膚萎縮は幼児期より前腕, 下腿の伸側ではつきりしており, ほとんどに体毛を伴つたが一部では脱落していた．基底細胞癌は42才時より顔面に初発し, 以後, 頭頸部や限界線照射の既往がある躯幹にも多発した．以上の臨床所見と, 頭髪, 発汗の異常はみられなかつたことを考えあわせ不完全型のBazex症候群と考えた．なお患者は22才時, 尋常性乾癬のため躯幹に限界線照射を受けたが, 両部にも多数の基底細胞癌が出現したことより, Bazex症候群患者には放射線治療は禁忌と考えた．


先天性上口唇正中瘻孔の1例

先天性上口唇正中瘻孔の1例


Postconfluent Hair Follicle Cellsに対するMinoxidilの影響


1.25-Dihydroxyvitamin D3のHair Follicle Cellに与える影響


Effect of Minoxidil on Cultured Human Hair Follicle Cells

Minoxidil (MX), whether applied topically or taken orally, has been said to increase the thickness and length of hairs. Knowing the functions of MX on the scalp hairs, we investigated the effect of MX on preconfluent human hair follicle cells in culture. The hair follicle cells used were derived from plucked scalp hair follicles according to the culture methods previously reported by us. Both plating efficiency and colony growth were supressed by MX at all the drug concentrations tested: 1, 10 and 100 <I>μ</I>g/ml. Cell morphology was not so affected by MX. Terminal differentiations such as stratification of cells and appearance of large denucleated cells were seen at all MX levels, as in the control. We found no evidence that MX activates the proliferation, or modulates the differentiation of HFC in vitro.

培養hair follicle cellsに対するminoxidilの影響について検討した．その結果, hair follicle cellsの増殖はテストしたすべてのminoxidil濃度(1, 10, 100<I>μ</I>g/ml)において抑制された．しかし, hair follicle cellsの形態的変化はみられず, 細胞の大型化, 核の消失, 重層化などの分化過程がコントロールとほぼ同様に観察された．


Xeroderma Pigmentosum with Diabetes Mellitus.:-A Report of 2 Cases plus Clinical and Biological Studies of 8 Cases of Xeroderma Pigmentosum Occurring in Tokushima-

糖尿病と尋常性乾癬の合併をみた色素性乾皮症 ―色素性乾皮症と内部臓器の老化について考察―

Two brothers with XP were found to be suffering from diabetes mellitus. The elder brother also had psoriasis vulgaris. XP is an autosomal recessive disease with an extensive heterogeneity in clinical features, and is characterized by cellular DNA repair deficiency. On the other hand, both ataxia telangiectasia and Fanconi's anemia are also autosomal recessive syndromes characterized by certain DNA repair defects. And it has been well known that patients (homozygotes) with these syndromes frequently develop diabetes mellitus. These observations led us to suppose that XP patients may also be predisposed to DM. Clinical and biological studies of 8 patients with XP in Tokushima have been carried out. Three patients of rather an old age (older than 48) had diabetes mellitus, and one had a hyperlipemia. The number of patients analyzed was very small, but it should be noted that the frequency of DM in XP patients might be high. We also report the first case of XP occurring together with DM and psoriasis vulgaris in Japan.

糖尿病(DM)を合併する色素性乾皮症(XP)の兄弟例を経験した．兄には尋常性乾癬も合併していた．XPはDNA損傷の修復に異常があるため, 皮膚に早期より老化症状が出現すると考えられる．一方Fanconi貧血やataxia telangiectasiaのような, DNA修復に異常がみられる疾患には糖尿病の合併がよく知られている．また早老症の代表であるWerner症候群は糖尿病の合併が普通である．これらのことより, 1985∼1987年に経験した8例のXP患者の内部臓器の異常について調べたところ, 3例にDMが, 1例に高脂血症がみつかつた．XPでは皮膚のみならず, 内部臓器にも, 早期より老化現象が出現する可能性があることを強調した．


脱毛を合併するビタミンD依存性クル病Ⅱ型の5症例

脱毛を合併するビタミンD依存性クル病Ⅱ型の5症例

紫外線照射により皮膚で合成されたり，または食物として摂取されたビタミンDは，肝臓と腎臓で水酸化を受け，ビタミンD作用(カルシウム代謝の調節など)を実際に発揮する1.25-dihydroxyvitaminD3(1.25(OH)2D3と略記)に変換される．1.25(OH)2D3は標的臓器細胞中の特異レセプターと結合し，DNAに働き，蛋白合成を介してホルモン効果を発揮する．この一連の機序のどこかに障害があるとカルシウム代謝異常症が出現する．1978年，Brooksらは，1.25(OH)2D3の合成，代謝は正常であるが，それに対する標的細胞内のレセプター異常の結果発症するクル病をビタミンD依存性クル病Ⅱ型(Vitamin D Dependent Reckets type II，以下DDR2と略記)として報告した．以後30例近く報告されているが，注目すべきことに大半の患者に脱毛がみられる．本邦でも6症例の報告を見るが，いずれも小児科，内科医により発表され，皮膚医にとってなじみの少ない疾患と思われる．しかし乳幼児，小児における脱毛の診察にあたっては，鑑別疾患の1つにあげねばなるまい．今回我々は脱毛を伴うDDR2の5症例を経験したので，主に脱毛についての考察を加えて報告する．


Duo DERMの採皮創に対する臨床経験 ―細菌検査を中心に―

Duo DERMの採皮創に対する臨床経験 ―細菌検査を中心に―


A Method for Culturing Human Hair Follicle Cells (III)

Hair Follicle Cellsの培養法(Ⅲ) ―至適培養条件の決定，とくに培養基質，Caイオン濃度の影響について―

The effects of substrates and medium ionic calcium concentrations on the growth and differentiation of human hair follicle cells in dispersed cell culture were investigated. Compared to other extracellular matrices such as collagen type I, fibronectin and laminin, a substrate of collagen type IV increased colony formation 3-7 fold. Colony growth of human hair follicle cells was doubled at medium ionic calcium concentrations of 0.3 mM compared to higher or lower levels, and terminal differentiation of human hair follicle cells was suppressed with lower calcium levels over the range 0.1∼0.9 mM.

各種培養基質および培地中Ca++濃度が抜去毛毛包由来hair follicle cellの増殖, 分化におよぼす影響について, dispersed cell cultureにて検討した．その結果, I型コラーゲン, フィブロネクチン, ラミニンに比較し, IV型コラーゲンを培養基質とした場合に最も有効にhair follicle cellのコロニーが得られた．また, 培地中Ca++濃度が0.3mMのとき, hair follicle cellは最もよくコロニーを形成した．Ca++濃度0.1∼0.9mMの範囲内でhair follicle cellの分化(角化, 重層化, cornified envelope形成など)は, Ca++濃度が低下するにつれて抑制された．


DICを合併した重症電撃傷の1例

DICを合併した重症電撃傷の1例


A Method for Culturing Human Hair Follicle Cells (II):-Plucked Human Hair Follicles-

Hair Follicle cellsの培養法(Ⅱ) ―抜去毛より採取した毛包の培養法―

We performed an explant culture and a dispersed cell culture of plucked hair follicles and could obtain hair follicle cell colonies without contamination of fibroblasts by both culture methods. To determine the optimal culture condition, MMC treated 3T3 cells, collagen type I membrane (undcr surface: 3T3 cells without MMC treatment) and collagen type IV were used as feeder layers or substrate. The hair follicle cell growth could be constantly viewed only on the collagen type IV coated dishes. Therefore, it is suggested that collagen type IV, a component of the basement membrane, is essential for the growth of hair follicle cells from plucked human hair follicles.

真皮成分の付着していない抜去毛毛包のexplant cultureおよびdispersed cell cultureを試み, 線維芽細胞の混在しないhair follicle cellのみのコロニーを得ることができた．マイトマイシンC処理した3T3細胞, 裏面に3T3細胞を培養したI型コラーゲン膜をfeeder layerとした場合に比較し, 基底膜の構成成分であるIV型コラーゲンを培養基質としたときに最も有効にhair follicle cellのコロニーが得られた．


A Method for Culturing Human Hair Follicle Cells (I):-A Method for Culturing Hair Follicles Obtained from Surgically Resected Scalp-

Hair Follicle Cellsの培養法(Ⅰ) ―手術摘出頭皮より採取した毛包の培養法―

We cultured human hair follicle cells from follicles of the surgically resected scalp skin. In the presence of calcium (1.96 mM), a physiological concentration, the cells piled up, keratinized and rapidly displayed a terminal differentiation, as seen in skin epidermal cells. Only when they were cultured from the start with a physiological calcium concentration medium and then with a low calcium concentration one (0.43 mM) did monolayered, polygonal and large nucleated basal cell-like cells appear, and were retained for about 20 days. To remove the fibroblasts which grow rapidly and surround hair follicle cell colonies in the course of culture, we scraped them off with a rubber policeman and the growth was suppressed to some extent.

手術時に摘出した頭皮より採取した毛包を材料として, 外毛根鞘由来の上皮系細胞であるhair follicle cells(HFC)の培養を試みた．通常Ca++培地では皮膚表皮細胞と同様に重層化·角化などの分化過程がみられた．次に通常Ca++培地にて培養を開始し, 7日目からHFCの分化を抑制する目的で低Ca++培地を使用したところ, 基底細胞と思われる細胞の単層のコロニーを約20日間にわたり維持観察できた．また, 培養経過中に優位となり, HFCを駆逐する線維芽細胞の抑制にはrubber policemanによる物理的削除を行い, 一定の効果をおさめた．


EFFECTS OF SIX TOPLCAL CORTLCOSTEROIDS ON DNA SYNTHESIS OF NORMAL HUMAN SKIN FIBROBLASTS

The Tokushima Journal of Experimental Medicine


マイボーム腺癌6症例の治療経験

マイボーム腺癌6症例の治療経験


Japanese Journal of Clinical Dermatology


遊離皮弁血行動態の研究-水素クレアランス法による-

遊離皮弁血行動態の研究-水素クレアランス法による-


Treatment of Patients with Darier's Disease with Topical Application of Solbase (a Mixture of Polyethylene Glycol 400 & 4000) Plus Occlusion

ダリエ病に対するポリエチレングリコールODT療法

Topical application of Solbase (a mixture of polyethylene glycol 400 & 4000) plus occlusion improved the eruptions of 2 patients with Darier's disease. To determine the mechanism of action, the effect of polyethelene glycol 400 on the rat epidermal DNA synthesis was investigated using autoradiography and doing 14C-thymidine incorporation studies. Seven days' topical application of polyethylene glycol 400 activated epidermal DNA synthesis nearly double the value seen in the control. This therapy should be considered for patients with Darier's disease and especially for whom retinoids cannot be prescribed.

2人のダリエ病患者にソルベース(ポリエチレングリコール400, 4000の合剤)のODTを行い皮疹の改善をみた．作用機序を知る目的で, ポリエチレングリコール400(PEG400)をラット皮膚に塗布し, 表皮DNA合成について14C-チミジンの取り込みとin vitroオートラジオグラフィー法でみたところ, PEG400塗布は表皮DNA合成を亢進させる結果を得た．この結果とPEGの持つ薬理学的性質を考えあわせ, ダリエ病に対する作用機序について考察した．また, ソルベースODT療法は, レチノイド内服が不可能なダリエ病患者に対して有効であることを述べた．


特異な瘢痕浸潤を示したサルコイドーシス

特異な瘢痕浸潤を示したサルコイドーシス