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Biomedical subjects

Hiko Hyakusoku

Publications and source records attributed to Hiko Hyakusoku.

At least 19 recordsLinked to original sources

Delayed extended "midthenar" flap for reconstruction of total fingertip avulsion injury and a proposal of ideal postoperative immobilization for a palmar flap.

Avulsion injury through the base of the distal phalanx of the ring finger with a large projecting tip of exposed bone was treated with delayed extended midthenar flap. The midthenar flap adding delay procedure at the first stage of a consecutive 2-stage operation could provide extended flap length to wrap the large projecting tip of the exposed bone at the second stage. This flap is useful for the middle and ring fingertip injury because motions of the all thumb joints are not restricted during the immobilization period. To reduce immobilization discomfort between the 2 stages of the palmar flap operation, a "relaxed flexion position" immobilization technique devised by the authors is also introduced.

Adult↗

Functional implications of the IL-6 signaling pathway in keloid pathogenesis.

The molecular mechanism(s) behind keloid pathogenesis remains unclear. Previously by global gene expression analysis of keloid fibroblasts (KFs), we implicated the IL-6 signaling pathway in keloid pathogenesis. Here, we determine a functional role of IL-6 signaling in keloid scars. Primary cultures of KFs and surrounding nonlesional fibroblasts (NFs) were subjected to induction or inhibition of IL-6 or its specific receptor IL-6 receptor alpha (IL-6R alpha) and detection of their effects on extracellular matrix gene expression. The levels of gp130 and several downstream targets in IL-6 signaling were also examined. IL-6 secretion was significantly higher in KFs than NFs. Addition of IL-6 peptide to NFs culture or inhibition of IL-6 or its receptor IL-6R alpha by their corresponding antibodies in KFs culture revealed a dose-dependent increase or decrease in collagen type I alpha 2 and fibronectin 1 mRNAs, respectively. Induction of IL-6 by IL-1beta peptide and stimulation by IL-6 peptide in NFs, or inhibition of IL-6 or IL-6R alpha in KFs cultures demonstrated a dose-dependent increase or decrease in procollagen I synthesis, respectively. The mRNA and protein expressions of gp130 and several downstream targets in IL-6 signaling (JAK1, STAT3, RAF1, and ELK1) were upregulated in KFs versus NFs. Our results indicate that IL-6 signaling may play an integral role in keloid pathogenesis and provide clues for development of IL-6 receptor blocking strategies for therapy or prophylaxis of keloid scars.

Adult↗

Central axis flap methods.

Extensively burned patients often lack ample healthy skin for autotransplantation. Scar contractures are then frequent. Here, we reconstructed contractures using flaps of remaining healthy skin around the recipient sites. In this report, we present four original scar contracture repair methods using subcutaneous pedicled flaps: (1) Propeller flap, (2) multilobed propeller flap, (3) scar-band rotation flap and (4) pin-wheel flap. The subcutaneous pedicle under the center of these various types of flaps allows these methods to be characterized as "central axis flap methods." We have employed these flaps to treat mild scar contractures in the axilla and cubital fossa. These methods are easily manipulated to restore function and improve aesthetics of scar contractures.

Adolescent↗

Fixation of intracapsular fractures of the condylar head with bioabsorbable screws.

A newly-developed fixation technique using bioabsorbable screws gave satisfactory results in fractures of the condylar head. The fracture lines ran obliquely (craniolateral to mediocaudal) on three-dimensional computed tomography. Two bioabsorbable screws were positioned vertically to the fracture lines. This technique is useful despite limited access to the condyle.

Absorbable Implants↗

Squamous cell carcinoma of the auricle arising from keloid after radium needle therapy.

The squamous cell carcinoma (SCC) of the auricle was one of the common tumors of not only skin but also ear. SCC of the auricle was described to be the carcinoma of old age with some predisposing factors and keloid was known to be one of the predisposing factors for malignant tumors. Keloid and radium needle therapy were risk factors, latter the major, independently from each other and were reported to conclude in SCC depending on the duration for the keloid and the dose for the radium needle therapy. The increased age with the long duration of these predisposing factors should have to be kept in mind in every situation when these treatment modalities had been planned to. Surgical interventions should always be the first choice in the treatment of not only the carcinomas but also in keloids in selected cases.

Aged, 80 and over↗

Clinical and anatomical study of superficial cervical artery flaps: retrospective study of reconstructions with 41 flaps and the feasibility of harvesting them as perforator flaps.

BACKGROUND: The superficial cervical artery musculocutaneous flap was first reported by Nakajima and Fujino in 1984; the present authors developed it for use as a skin flap in 1990, and in 1993, they succeeded in harvesting it as a free flap. Since 1986, they have harvested 41 superficial cervical artery flaps of various types from 32 patients to reconstruct head and neck scar contractures and intractable ulcers. METHODS: In a retrospective clinical study, the authors classified these 41 flaps into three types according to their pedicles: musculocutaneous pedicled flaps (n = 5); muscle pedicled flaps (n = 14), and vascular pedicled flaps (n = 22). In an anatomical study, they harvested 10 flaps from five preserved cadavers and took microangiograms of the trapezius muscle and dorsal skin to identify the distribution of the superficial cervical artery. RESULTS: Thirty-six flaps survived completely, and both the aesthetic and functional results were good. Among the other five flaps, partial necrosis was observed in four and complete necrosis was seen in one. Among the 36 surviving flaps, 23 were more than 30 cm long. CONCLUSIONS: The authors fully confirmed from their clinical and anatomical studies that the superficial cervical artery flap is useful for reconstruction of the head and neck regions. In each flap, the superficial cervical artery was found to be a "transverse cervical perforator" or "trapezius perforator" and was large enough to be used as a vascular pedicled flap, suggesting that it can be elevated as a "perforator flap."

Adolescent↗

Clinical imaging diagnosis of implant materials for breast augmentation.

BACKGROUND: The ingredients of substances implanted for breast augmentation sometimes remain unknown due to lack of information from patients. Significant clinical problems sometimes necessitate removal and reconstruction. Thus, preoperative diagnostic imaging to identify the ingredients of implants may improve the treatment decision-making process. In this report, we created a clinical imaging index. PURPOSE: Here, we summarize computed tomography (CT) and magnetic resonance imaging (MRI) imaging of implant materials to predict the ingredients of implant substances preoperatively. METHODS: A total of 104 patients with late complications after receiving breast augmentations between 1971 and 2002 were examined using CT and MRI. In addition, further examinations were conducted, including postoperative chemical analysis using Nuclear magnetic resonance (NMR) spectroscopy and MRI imaging of various implanted substances using an experimental magnetic resonance system. RESULTS: We identified the ingredients of implant materials used for breast augmentation by imaging diagnostics as follows: silicone: radiopaque-low/high (CT-MRI T1/T2); hydrogel: radiolucent-low approximately iso/high; hydrocarbon: radiolucent-high approximately iso/low approximately iso; saline: radiolucent-low/high. CONCLUSION: We have identified by imaging diagnosis the ingredients of implant materials.

Adult↗

Does a bone deformity of the distal phalanx undergo remodeling after removal of a congenital ectopic nail?: A case with periodic radiographic follow-up.

BACKGROUND: Congenital ectopic nails are rare and are characterized by the presence of nail-like tissue mainly at the tip of a finger or toe. OBJECTIVE: Although the accompanying bone deformity might undergo remodeling after removal of the ectopic nail, it remains unknown whether complete bone remodeling can be eventually achieved, and whether such remodeling is necessary to improve the final cosmetic appearance of the concerned fingertip. METHODS AND RESULTS: Follow-up with periodic radiographic examination for 1 year after surgery in a child with congenital ectopic nail revealed no bone remodeling, despite the satisfactory cosmetic result. CONCLUSION: We conclude that residual bone deformity does not affect the final appearance.

Bone Diseases↗

An anatomical study and clinical cases of 'super-thin flaps' with transverse cervical perforator.

We present a microangiogram study and clinical cases of super-thin flaps based on a transverse cervical perforator. This flap is the first to use the perforator of the superficial branch of the transverse cervical artery. This flap is more useful for providing colour and texture matches than a skin graft, and it is easier to harvest the flap than a free flap because it is a kind of skin flap.

Adult↗

The scar band rotation flap.

This study presents cases in which postburn scar contractures of finger joints and interdigital spaces have been reconstructed using a scar band rotation flap. The scar band rotation flap is a subcutaneous pedicled skin island flap consisting of a contracture-causing scar band, the graft surface and normal skin. After flap rotation, the normal skin in the flap divides the scar band, thus releasing the scar contracture. In the past 10 years, we have used this reconstruction method to treat seven patients (three males and four females) ranging in age from 4 to 72 years. In all patients, the cause of the scar contractures was marginal scarring of a life-saving skin graft that was used to treat extensive burns. We reconstructed four finger joints and eight interdigital space contractures and obtained favorable results with no flap loss. We have found this method to be useful for the reconstruction of small scar contractures in locations such as finger joints and interdigital spaces after skin grafting to treat extensive burns.

Adult↗

Simultaneous bilateral breast reconstruction with autologous tissue transfer after the removal of injectable artificial materials: a 12-year experience.

BACKGROUND: Over the years, breast augmentation with injectable artificial materials has presented significant clinical and social problems, particularly in Japan, because of later complications. The authors have used autologous tissue to treat patients who want not only to have these materials removed but also to maintain breast contour. The purpose of this study was to review the clinical outcome of the authors' reconstruction procedures retrospectively. METHODS: A total of 38 breasts in 19 consecutive cases treated between 1991 and 2002 were reviewed. The patients were all women, ranging in age from 41 to 70 years old (mean age, 53.4 years). The average period from injection to reconstruction was 26.5 years. After removal of the injected materials, both breasts were simultaneously reaugmented with deepithelialized rectus abdominis flaps. The incidence of associated complications was investigated. RESULTS: The 38 flaps consisted of 31 free transverse rectus abdominis musculocutaneous flaps, five pedicled transverse rectus abdominis musculocutaneous flaps, and two pedicled vertical rectus abdominis musculocutaneous flaps. Three flaps with total necrosis (7.9 percent) because of venous thrombosis were found in two cases. Partial flap necrosis was observed in six flaps (15.8 percent). Hematoma requiring a surgical procedure occurred in one case (5.3 percent). Negligible abdominal bulging requiring no additional procedure was found in seven cases (36.8 percent). CONCLUSIONS: The complication rate seemed to be relatively high compared with that for breast reconstruction after mastectomy. Nevertheless, autologous tissue transfer may be one of the ideal procedures for breast reaugmentation after the removal of injectable materials, because affected patients prefer not to undergo reaugmentation with other artificial materials.

Adult↗