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Biomedical subjects

K Harii

Publications and source records attributed to K Harii.

At least 91 records · Page 5Linked to original sources
PubMed1996

Comparison of end-to-end and end-to-side venous anastomosis in free-tissue transfer following resection of head and neck tumors.

A comparative study was conducted of the results of venous end-to-end and end-to-side anastomosis in 948 clinical cases of microvascular free-tissue transfers for head and neck reconstruction following tumor resection. End-to-side anastomosis to the internal jugular vein was achieved uneventfully in the present series, while a variety of recipient veins was used for end-to-end anastomosis. The incidence of thrombosis was 1.8% (15/835) in the end-to-end anastomosis group and 2.7% (3/113) in end-to-side venous anastomosis. No statistical difference was observed between the two groups. One may hesitate to perform end-to-side anastomosis because of unfamiliarity, concern over technical difficulty, and unreliability. As a result of our statistical analysis, we are convinced that end-to-side anastomosis directly to the internal jugular vein, whenever available, is the preferred procedure in microvascular free-tissue transfers for reconstruction of the head and neck following tumor resection.

Adolescent↗
PubMed1996

A spheno-orbital encephalocele with unilateral exophthalmos.

Encephaloceles are rare congenital defects in the skull, through which the meninges and brain tissue have herilated. We report a case of an 11-year-old boy with a spheno-orbital encephalocele that presented with pulsatile exophthalmos. A two-stage operation resulted in a good outcome.

Child, Preschool↗
PubMed1996

Selective reduction in alpha-hydroxypalmitic acid-containing sphingomyelin and concurrent increase in hydroxylated ceramides in murine skin tumors induced by an initiation-promotion regimen.

The sphingomyelin cycle is activated to accumulate ceramides in the process of epidermal differentiation. We found that sphingomyelin in the epidermis of 4 different murine strains gave three bands on TLC, the lower band containing alpha-hydroxypalmitic acid (C16h:0(alpha)). However, in the papillomas induced in the skin of SENCAR and SSIN mice by initiation with 7,12-dimethylbenz[a]anthracene followed by promotion with 12-O-tetradecanoylphorbol acetate, the concentration of C16h:0(alpha)-containing sphingomyelin was selectively diminished with a concomitant increase in the concentrations of the ceramides containing alpha-hydroxy fatty acids. These findings indicate a possible involvement of the selective hydrolysis of alpha-hydroxy fatty acid-containing sphingomyelin in the process of tumorigenesis in mouse skin.

Animals↗
PubMed1996

Aging effects in skeletal muscle recovery after reinnervation.

To investigate the influence of age on the process of muscle recovery after nerve repair, the nerves of the right extensor digitorum longus (EDL) and the right soleus muscles of 63 2-month-old and 61 15-month-old rats, respectively, were transsected and resutured. At four, eight, 16, and 24 weeks after nerve repair, functional recovery of the muscle was assessed by electromyographic (EMG) recordings and isometric muscle contraction. Muscle weight, morphological, and morphometric studies were also done. At four and eight weeks after nerve repair the younger age groups showed higher rates of recovery compared with the control side (left EDL and soleus) (recovery rate (%) = operated/control x 100) than the older age groups, and the recovery rates of soleus (slow twitch muscle) in both age groups were higher than EDL (fast twitch muscle). However, the differences between the two age groups decreased at 16 and 24 weeks after nerve repair in both muscles. We therefore conclude that earlier differences were the effects of nerve regeneration on the muscle between different ages and the reason for the reduced differences at later stages was that after reinnervation began, not only the nerve but also the muscle recovered successfully in older age groups, and slow motor units reinnervated faster than the fast units in both age groups. Our present study shows that the older age groups also have a good prognosis for recovery of muscle function after nerve repair.

Aging↗
PubMed1996

Surgical treatment of mandibular osteoradionecrosis: versatility of the scapular osteocutaneous flap.

Osteoradionecrosis of the mandible is a serious complication of radiotherapy for head and neck cancer and no single treatment has to date met with consistent success. A free scapular osteocutaneous flap was successfully transferred in nine patients with mandibular osteoradionecrosis who before this had not responded to conservative treatment. All but one of the patients had good bone union and there was no evidence of recurrence during a mean follow up period of four years and one month. This flap not only provides a well-vascularised segment of the bone but also multiple, large skin paddles, each with an abundant and reliable blood supply. In addition, well-vascularised fascia and overlying subcutaneous tissue can be used to fill dead spaces and cover the bony segment and fixation plates. This reduces postoperative infection and promotes primary wound healing. This flap has proved useful for reconstruction of mandibular osteoradionecrosis, particularly when there is a large soft tissue defect.

Adult↗
PubMed1996

Free colon transfer: a versatile method for reconstruction of pharyngoesophageal defects with a large pharyngostoma.

Free transverse colon transfers based on the middle colic vessels were used to reconstruct a pharyngoesophageal defect in 9 patients. In all patients, cancer invaded up to the oropharynx. Resection resulted in a larger pharyngostoma than normally seen following standard total pharyngolaryngoesophagectomy. In such cases, it can be difficult to achieve good swallowing function after reconstruction using the free jejunal transfer. This mainly results from a significant discrepancy between the diameter of the pharyngostoma and that of the jejunum. Compared to the jejunum, the transverse colon has a larger diameter with a longer vascular pedicle and can provide a longer, straight intestinal tube, facilitating easy passage of a food bolus. In our series, all transfers survived well and all patients had good swallowing function postoperatively. We consider that a free colon transfer is more suitable than a free jejunal transfer for pharyngoesophageal reconstruction in patients with a large pharyngostoma.

Aged↗
PubMed1995

Electromyographic study of functional recovery of free vascularized muscles grafted to the face.

The functional recovery of gracilis muscles grafted for treatment of facial paralysis in combination with a cross-face nerve graft was evaluated on the basis of electromyography in 98 cases. Initial action potentials were recorded, on average, 8 months after transplantation. There was a tendency for such potentials to appear earlier in the case of patients who finally attained good muscle activity. Action potentials were polyphasic in the early stage and of short duration and low amplitude. An increase in the amplitude and duration of potentials and a shortening of the distal latency were observed with increase in the numbers of reinnervated muscle fibers. Thereafter, there was a tendency toward decreases in the duration and number of spikes due to the increasing similarity in the distal latency of each neuromuscular unit. The grafted gracilis muscles attained a stable state about 1 year after the initial recording of action potentials. It was expected that spontaneous action potentials during rest might serve to indicate the condition of reinnervation. Their absence during the first few months after transplantation may suggest necrosis of the grafted muscle, while those of long duration and high amplitude observed after 1 postoperative year may be suggestive of disturbance in the reinnervation process. In this study, we could not find any significant difference in the reinnervation process between that of a gracilis muscle grafted following a cross-face nerve graft and a muscle reinnervated following nerve transection and repair. We therefore believe that free gracilis muscle transplantation combining a cross-face nerve graft is appropriate for the reconstruction of muscle function.

Action Potentials↗
PubMed1995

Follow-up study of patients treated for ingrown nails with the nail matrix phenolization method.

In the past 7 years, a total of 537 ingrown nail lesions were treated with the nail matrix phenolization method (NMP). A study was performed based on follow-up examinations and a questionnaire survey regarding recurrence rate, degree severity, duration of postoperative pain, and other relevant factors. The major advantages of the NMP revealed by our study were: (1) The surgical procedure is easy to perform and does not require specialized equipment; (2) total time requirement for surgery is minimal; (3) the operation can be performed in the presence of a concomitant infection; (4) the recurrence rate is low (1.1%); and (5) postoperative pain and postoperative bed rest is minimized. These results indicate that NMP is an extremely effective method for treatment of ingrown nails.

Adolescent↗
PubMed1995

Versatility of a cross-leg free rectus abdominis flap for leg reconstruction under difficult and unfavorable conditions.

A cross-leg free rectus abdominis flap, anastomosing to utilized "carrier" vessels of the contralateral noninjured leg, was used for reconstruction in six cases of extensive traumatic defects and deformities of a lower extremity. This method provides great advantages in free-flap reconstruction of complicated and unfavorable cases in which utilization of what would be suitable recipient vessels in the injured leg is most difficult, but there is good blood circulation of the leg.

Adult↗
PubMed1995

Enhancement of adhesive property of epithelial cell line Mm2T by culture in the presence of methylated vitamin B12.

A thymic epithelial cell line Mm2T was cultured in a medium containing a high concentration (100 micrograms/ml) of methylated vitamin B12 (CH3-B12). After 19 days, cells were found to have a flat phenotype, to have lost the floating cells which were observed in the control cells at the confluent stage, and to have acquired a resistance to trypsin. However, treatment of the CH3-B12-treated cells with EDTA resulted in a dissociation of cell-to-cell contact and reaggregation was achieved by addition of Ca2+, indicating the involvement of Ca2+ ion in cell-to-cell contact. Electron microscopic analyses revealed that the CH3-B12-treated cells were nearly square in their vertical section, which was in contrast to the dome-shaped feature of the control cells, and their cell-to-cell contact area was significantly widespread, as compared to those of the control, indicating that Mm2T cells acquires an adhesive property by treatment with CH3-B12. Biochemical analyses of both cells indicated that the concentration of glucosylceramide in the CH3-B12-treated cells was higher than that of the control. Free glucose characteristically inhibited the reattachment of cells dissociated with EDTA, suggesting the involvement of glucose in the cell-to-cell adhesion of CH3-B12-treated cells. In addition, WGA-binding glycoconjugates were intensely observed in the boundary region of CH3-B12-treated cells by immunohistochemical staining, but not in that of the control cells. It is suggested that CH3-B12 may affect the morphological alteration of Mm2T by enhancing cell adhesion through elevated expression of the C-type lectin.

Animals↗
PubMed1995

Electrophysiological, morphological, and morphometric effects of aging on nerve regeneration in rats.

To investigate the influence of age on the process of nerve regeneration, the right common peroneal nerves of 14 2 month old and 14 10 month old rats were transected and resutured. At four and eight weeks after the nerve repair, the motor nerve conduction velocity (MNCV), latency, and amplitude of the evoked potential from the peroneus longus muscle were measured. The number of regenerated myelinated fibres, axon diameter, axon area, axon circumference, and myelin thickness were also measured. Compared with the control side (left common peroneal nerve and muscle), MNCV, latency, and amplitude showed higher recovery rates (recovery rate (%) = operated/control x 100) in 2 month old rats than in 10 month old rats, particularly at four weeks after the operation. In the morphometric study, axon diameter, axon area, and myelin thickness also recovered more quickly (recovery rate (%) = operated/control x 100) in 2 month old rats, particularly four weeks after the operation. Morphologically, myelin remnants were not found in 2 month old rats eight weeks after the operation, though they remained in 10 month old rats. These studies show that the recovery rate was significantly greater in 2 month old rats than in 10 month old rats. The explanation seems to be the difference in the speed of Wallerian degeneration, axonal regeneration, and myelin regeneration.

Age Factors↗
PubMed1995

A comparison of temporal muscle transfer and lid loading in the treatment of paralytic lagophthalmos.

Temporal muscle transfer (n = 78) and lid loading with a gold plate (n = 52) were compared in the treatment of paralytic lagophthalmos. Three sizes of gold plate (1.0, 1.2 and 1.4 g) were used. Lid loading was inferior to temporal muscle transfer in improving functional ability to close the eye, but it did protect the cornea from irritation. There were no significant differences among the sizes of plate, but there was most relief from corneal irritation when the 1.4 g gold plate was used. The plate had to be removed in 25% of the patients, but this did not make the condition worse than before lid loading. Lid loading has the advantage that patients can close their eyes without conscious effort. We therefore recommend lid loading as the first choice for correction of paralytic lagophthalmos, and that temporal muscle transfer should be undertaken after plate removal in only those patients for whom lid loading has not given a satisfactory result.

Adolescent↗
PubMed1995

Free vascularized double muscle transplantation for the treatment of facial paralysis.

Two cases of free neurovascular double muscle transplantation for facial paralysis are reported, with detailed descriptions of the operative technique and follow-up study. The latissimus dorsi muscle segment is placed between the nasolabial fold and the zygoma to substitute for the zygomatic and levator labii muscles, while the serratus anterior muscle segment is placed between the lower lip and the mandibular margin to substitute for the depressor labii muscles. The thoracodorsal nerve is sutured to the stump of the cross-face nerve graft, and the lateral thoracic nerve is sutured to a part of the hypoglossal nerve. The procedure is able to restore a relatively symmetrical smile, especially in patients with a full denture smile. The satisfactory results of this procedure are expected to lead to new prospects in the treatment of facial paralysis.

Adult↗
PubMed1994

Programmed expression of cholesterol sulfotransferase and transglutaminase during epidermal differentiation of murine skin development.

To clarify the role of cholesterol sulfate (CS) in the process of epidermal differentiation in vivo, we investigated the concentration of CS and the specific activities of cholesterol sulfotransferase (CST), cholesterol sulfate sulfatase (CS sulfatase) and epidermal transglutaminase (ETG) in murine skin in the pre- and postnatal periods. In the skin at day 14 of gestation, CS was not detected with TLC and the specific activities of all the enzymes were low. However, concomitant with the formation of the multilayered structure of the epidermis (at day 16), the specific activities of CST steeply increased. Although the insoluble CS sulfatase in the microsomal fraction remained at a relatively constant level, the soluble CST in the cytosol fraction showed a 6-fold increase from day 14 to day 16, and the activity decreased continuously in the following period, reaching one forty-sixth of the maximum level at 4-months-old mice. Reflected by the increase in activity, CS was detected in fetal skin at day 15, and the concentration in epidermis significantly increased during the gestation period, reaching maximum level at day 17. Furthermore, the changes in the concentration of cholesterol sulfate were identical with those of N-(O-linoleoyl)-omega-hydroxy fatty acyl sphingosine and its glucosyl derivative in the epidermis. On the other hand, the specific activity of ETG increased after birth. Thus, the activation of CST and ETG was shown to occur separately in association with the formation of the multilayered structure and thickening of the stratum corneum, respectively.

Animals↗
PubMed1994

Mediastinal tracheostomy during esophagectomy for cervicothoracic esophageal carcinoma invading the proximal trachea.

A total of 16 patients with carcinoma in the cervicothoracic esophagus underwent pharyngolaryngoesophagectomy with construction of a mediastinal tracheostoma. Among them, seven patients underwent transhiatal esophagectomy without thoracotomy, four proximal esophagectomy by cervicotomy and sternal split, and five cervical and thoracic esophagectomy and lymphadenectomy by cervicotomy and right thoracotomy. Free jejunal transfer was performed to reconstruct the esophagus in five patients, and the stomachs were used in ten. One patient died of pneumonia 27 days after surgery, and two of arterial blowout. Plastic and reconstructive surgery techniques were introduced to protect large vessels and cover the wound. The postoperative 30-day mortality was 6.3% and the total operative mortality was 18.8%. Median survival was 327 days. Mediastinal tracheostomy is safely applicable today for patients with esophageal carcinoma invading the proximal trachea, allowing them to achieve safe respiration and to enjoy meals.

Aged↗
PubMed1994

An inferior rectus abdominis bridge flap for revascularization of an ischemic tongue.

Ablative surgery to completely eradicate cancer may injure or necessitate ligation of major vessels. Unplanned necrosis of intact adjacent tissues and/or organs may result due to insufficient blood supply. We report a case in which a free inferior rectus abdominis musculocutaneous flap was successfully used as a bridge flap. Reconstruction of a soft tissue defect as well as revascularization of an ischemic organ (the tongue) was simultaneously achieved with a single flap transfer. To the best of our knowledge, this is the first report of a free inferior rectus abdominis musculocutaneous flap used successfully as a bridge flap.

Adult↗
PubMed1994

Long-term follow-up study of browlift for treatment of facial paralysis.

Browlift for patients with irreversible paralysis of the frontalis muscle was evaluated in a review of 40 patients who had undergone follow-up studies for durations of more than 3 years. The procedure consists of a lazy S-shaped excision above the upper border of the eyebrow and upward fixation of the lower skin margin. The results were as follows: (1) The percentage of patients for whom symmetrical positioning of the eyebrow was achieved was 65%. (2) The greater the preoperative severity of ptosis, the more often did recurrence occur. (3) Recurrence progressed rapidly during the first postoperative year, but thereafter recurrence was seen only in those patients in whom the affected eyebrow was still in a position higher than its counterpart. (4) No relationship could be seen between age at the time of surgery and postoperative position of eyebrow. (5) Improvement in contraction of the visual field was seen in 85% of patients postoperatively, and complaints were eliminated in 50%. (6) Careful preservation of the sensory nerve is required. (7) The postoperative scar was acceptable. This procedure is a simple and effective method of correction of paralytic ptosis. Although a degree of skill is required to obtain satisfactory results and a surgical scar remains at the upper border of the eyebrow, the advantages of the procedure surpass its disadvantages. It is believed that this method should be used more often in the treatment of facial paralysis.

Adolescent↗