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Biomedical subjects

K Harii

Publications and source records attributed to K Harii.

At least 145 records · Page 8Linked to original sources
PubMed1987

Oral and pharyngeal reconstruction using the free forearm flap.

Recent progress in myocutaneous and free flaps has facilitated the primary closure of various complex defects resulting from ablative surgery of head and neck cancers. The musculocutaneous flap (such as the pectoralis major flap or the latissimus dorsi flap) has in particular proved its greater versatility. The forearm free flap for intraoral defects can provide thin and pliable skin and has great potential in the reconstruction of oropharyngeal defects. Between November 1982 and August 1985, we achieved 74 free forearm flap transfers for patients with head and neck cancers. Herein we present several clinical applications of the free forearm flap and discuss its advantages and disadvantages, especially hand morbidity after flap elevation.

Adult↗
PubMed1987

The development of bone after perichondrial grafting: an experimental study using ear and rib perichondrium in rabbits.

The development of bone after perichondrial grafting was investigated using rabbit ear and rib perichondrium. Sixty-four white adult female rabbits were used. Both free and vascularised perichondrial grafts were undertaken. In each case the chondrogenic potential of perichondrium was proved. Furthermore, when the perichondrium was vascularised or grafted in recipient sites having good blood circulation, the development of large areas of bone was observed around the regenerated cartilage.

Animals↗
PubMed1987

Primary esophageal reconstruction after resection of the cancer in the hypopharynx or cervical esophagus: comparison of free forearm skin tube flap, free jejunal transplantation and pull-through esophagectomy.

Sixty-six patients with carcinoma of the hypopharynx or cervical esophagus received esophageal extraction and primary reconstruction. The methods of reconstruction were free forearm skin tube grafting, free jejunal transplantation and immediate pharyngo-gastrostomy after pull-through esophagectomy. Considering the postoperative complications of each method, free forearm skin tube transplantation is the safest, but it can only be used for a short defect of the esophagus. With pull-through esophagectomy, we are able to extract the whole esophagus and have no fear of leaving any remaining cancer in the thoracic esophagus, but the operative burden and the rate at which complications occur are higher. Free jejunal transplantation can be used for a short or long defect of the cervical esophagus with small operative burden. Among three methods of reconstruction, free jejunal transplantation is recommended for primary reconstruction of the cervical esophagus.

Esophageal Neoplasms↗
PubMed1987

[The role of plastic surgery in the treatment of cancer and its progress].

Advances in the treatment of cancer have resulted in the long survival of patients afflicted with various types of cancers. Many patients, however, still suffer post-treatment sequelae which frequently prevent patients from returning to a normal life style. Plastic surgery procedures facilitate the immediate coverage of large and complex tissue defects after either radical ablation of cancer or heavy irradiation, the recovery of lost functions and the reconstruction of body contours. The modern techniques of plastic surgery and advance such as musculocutaneous flaps and microsurgical free tissue transfers are introduced.

Breast Neoplasms↗
PubMed1986

Significance of deep body thermometer for assessing haemodynamics of free flaps.

A deep body thermometer was used in 13 cases of microvascular tissue transfer in order to assess the post-operative haemodynamics of the flaps. Nine of 10 cases involving free skin flaps demonstrated good blood flow by the temperature recovery curves in cooling and rewarming (CR) tests conducted immediately and 6 to 12 hours after operation but in the tenth, anastomotic problems were predicted by the tests. None of the three musculocutaneous flap cases demonstrated good blood flow patterns initially but two were good at 6 hours and did well. The third had a poor pattern at 6 hours and suffered partial necrosis. This study confirmed that it is possible to assess the state of circulation in a flap by the CR test after free flap transfer.

Adolescent↗
PubMed1986

Vascularized periosteal grafts: an experimental study using two different forms of tibial periosteum in rabbits.

Three groups of rabbits were studied to investigate the osteogenic capacity of vascularized periosteum. It was found that such tissue, especially in the form of musculoperiosteal flaps, produced a significant amount of bone. It is concluded that vascularized periosteal flaps have an excellent osteogenic capacity even though they are not subjected to weight or stress.

Animals↗
PubMed1985

Experimental study of vascularized nerve grafts: multifactorial analyses of axonal regeneration of nerves transplanted into an acute burn wound.

Rat sciatic nerves were used in a comparative study of both vascularized and free nerve grafts that were transplanted into an acute burn wound. Electromyographic analyses of axonal regeneration were done at intervals from week 1 through week 24 after surgery. Biopsied sciatic nerves were processed for morphometric studies with the use of a fiber caliber analyzer. Motor nerve conduction velocity was faster in the vascularized nerve graft than in the free nerve graft until week 24 after surgery. Regenerated axons appeared earlier in the vascularized nerve grafts than in the free nerve grafts, and the density of large regenerated axons was greater in the former than in the latter group. It is suggested that preserving the vascular system of vascularized nerve grafts would decrease the likelihood of fibrosis and result in smooth regeneration of axons.

Animals↗
PubMed1985

Radial forearm flap in reconstruction following surgery for head and neck cancers.

The forearm flap developed in China provided a most useful addition to the field of head and neck reconstruction. Because of its thin and pliable components, long and large caliber pedicle vessels and reliable vascularity, etc., we prefer to use the microvascular transfer of this flap for reconstruction of oral, oropharyngeal, and hypopharyngeal regions following cancer ablation and recognize further evidence of the versatility of this flap. In this paper, we describe the techniques of forearm flap transfer and the results of 37 cases experienced between March, 1983 and October, 1984.

Forearm↗
PubMed1985

Experimental study of vascularized nerve grafts: morphometric study of axonal regeneration of nerves transplanted into silicone tubes.

Rat sciatic nerves were used in a comparative study of vascularized and free (nonvascularized) nerve grafts transplanted into silicone tubes. A total of 39 sciatic nerves were used, 21 as vascularized nerve grafts and 18 as free nerve grafts. The rats were killed at intervals from the first to the 24th postoperative weeks, and biopsied sciatic nerves were processed for morphometric studies using a fiber caliber analyzer. There was a significant increase in the number of large myelinated axons (more than 5 mu) in the vascularized nerve graft models over those in the free nerve graft models at the distal ankle region. Furthermore, the diameters of myelinated axons in the vascularized nerve graft were larger than those in the free nerve graft at all specimen sites during all postoperative weeks. We suggest that the preservation of the vascular system in vascularized nerve grafts would decrease the likelihood of fibrosis and result in better regeneration of axons.

Animals↗
PubMed1985

Pharyngoesophageal reconstruction using a fabricated forearm free flap.

A new microsurgical alternative in reconstruction of the pharynx and cervical esophagus is reported. A trapezoidal forearm flap is fabricated into an inverted skin tube and placed in the pharyngoesophageal defect. Although microvascular anastomoses are required to revascularize the transferred forearm flap, the long and large nutrient vessels of the flap make anastomoses easy and reliable. None of our 12 patients demonstrated any necrosis of the transferred flap. This one-stage, less invasive operation for pharyngoesophageal reconstruction greatly benefits older persons, who are the more likely to be involved with pharyngoesophageal carcinomas.

Aged↗
PubMed1984

Reconstruction of the esophagus by microvascular surgery.

After esophagectomy, free jejunal autografts were used for reconstruction in 11 patients and pedunculated colons in two patients. A microvascular technique was applied immediately after the resection. A vascular anastomosis gave a new blood supply for the free jejunal graft, and in the case of the pedunculated colon gave support to improve circulation. During the grafting procedure, neither cooling nor heparinization was needed. No graft failures have occurred. The main complication of free jejunal grafts was leakage of the proximal anastomosis of the bowel, but all three leakages healed spontaneously. Two supportive vascular anastomoses for the pedunculated colons were effective and caused no complication. All 13 patients could eat regularly at the time of their discharge.

Aged↗
PubMed1982

Closure of total cheek defects with two combined myocutaneous free flaps.

Closure of a large, full-thickness defect after radical ablation of advanced cancers in the oropharyngeal region has often presented problems. We designed the one-stage, microsurgical free transfer of two musculocutaneous flaps-the latissimus dorsi flap and the serratus anterior flap-with one common nutrient pedicle formed by the thoracodorsal vessels. The serratus anterior flap was turned into the buccal mucosal defect, while the latissimus dorsi flap was placed in the cheek cutaneous defect. The flaps were then revascularized by anastomosing the nutrient thoracodorsal vessels to the selected recipient vessels. This particular procedure was successfully achieved in two clinical cases with large, full-thickness defects in the cheek. Functional disabilities after removal of two muscles were unexpectedly minimal in both cases.

Cheek↗