Biomedical subjects
Publications and source records attributed to T Onizuka.
Microform cleft lip is a mild expression of cleft lip and may be difficult to repair. Its severity may be defined by the degree of downward depression of the nostril rim, skin striae of the upper lip, notching of Cupid's bow, and deformity of the vermilion border. Variation in surgical repair is reported for each type of microform cleft lip.
Hypothermia has many valuable merits compared with under cardiopulmonary bypass using pump oxygenator, as known. But, on the contrary, it has some weak points, such as, long time required for cooling and rewarming. We have developed the device for rapid cooling and rewarming by using jet water blows. It appeared that the key point in hypothermia was control of ether inhalation and timing of rewarming. We demonstrated that mongrel dog could survive for at least 72 hours after transplantation of heart-lung under simple deep hypothermia with ether anesthesia. The dog was breathing 50-100 percent oxygen gas under control through respiratory ventilator. Postoperative arterial blood gases were maintained between pH 7.3-7.5 and PO2 80-200mmHg on the other hand, PCO2 was unstable from 14 to 63mmHg. It seemed that the anesthesia in canine heart-lung transplants using profound surface hypothermia with either anesthesia was useful methods.
The results of repairing cleft lip by aesthetic plastic surgery are now excellent. However, the cleft lip-nose deformity is still very difficult to repair with the present techniques. A technique that can repair the cleft lip-nose deformity with good results is presented. The technique is divided into three parts: Part I consists of nasal repair of the primary cleft lip. Part II is nasal reconstruction as a secondary operation with or without lip repair. For example, nasal reconstruction may be secondary to repair of deformities of the sill, rim, limen nasi, septum, or nasal bones. Part III is an aesthetic nasal operation such as rhinoplasty, mentoplasty, or zygomaplasty.
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The physiologic effects of pulsatile and non-pulsatile flow in cardiopulmonary bypass were compared in terms of the relationship between different flow rates and what effects these had on pulsatile and non-pulsatile flow. Forty adult mongrel dogs were used in this study and divided into 5 groups, each comprised of 8 animals, according to the flow rate during cardiopulmonary bypass, namely; 40, 60, 80, 100, or 120 ml/kg/min. The animals were perfused with either pulsatile or non-pulsatile flow for 1 hour, given randomly at the same mean flow rate. At flow rates of 80 and 100 ml/kg/min, the mean arterial blood pressure and total peripheral vascular resistance were significantly lower in pulsatile flow than in non-pulsatile flow, and the renal blood flow was significantly greater in pulsatile flow than in non-pulsatile flow. The renal arterial-venous lactate difference was significantly less in pulsatile flow than in non-pulsatile flow at a flow rate of 80 ml/kg/min, and the renal lactate extraction was significantly higher in pulsatile flow than in non-pulsatile flow at the same flow rate. The renal excess lactate was significantly lower in pulsatile flow than in non-pulsatile flow at a flow rate of 100 ml/kg/min. There were no significant differences in these parameters between the two types of perfusion at flow rates of 40, 60 or 120 ml/kg/min. Pulsatile flow was therefore apparently advantageous, when compared to non-pulsatile flow, in terms of hemodynamics, renal circulation, and metabolism of the kidney at flow rates of 80 and 100 ml/kg/min. However, when the flow rate was 120 ml/kg/min, pulsatile flow and non-pulsatile flow had the same effects.
The fasciocutaneous flap in the lower leg has been widely used since Pontén's 1981 report. The cutaneous artery running along the sural nerve--known as the superficial sural artery--has an important role in the blood supply of the fasciocutaneous flap in the lower leg as stated by Haertsch. The superficial sural artery has great variation with regard to its location and the origin of the vessel. The cutaneous artery is intimately connected to the sural nerve or the lateral sural nerve. It may run along the sural nerve or along the lateral sural nerve. We examined this vessel in 10 cadaver dissections and applied it in 17 clinical cases of pedicled, island, and free flaps. The island sural fasciocutaneous flap is particularly versatile for the reconstruction of the soft tissue defect around the knee joint. The operative procedure involving the island fasciocutaneous flap and the characteristics of this sural fasciocutaneous flap are described.
Augmentation rhinoplasty using a silicone implant is the most popular operation in Japan, but is not without several complications such as exposure of the implant and its deviation. We obtained good results in preventing these complications by a fixation at the hollow which is made by chiseling the frontal bone and by fibrous tissue which grows through the small holes of the implant tail.
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Two operative scar lines remain after bilateral cleft lip repair. A method has been devised in which the two scar lines are reduced into one. The characteristics of this method include (1) an inconspicuous scar, (2) elevation of the nasal tip using the prolabium, (3) repair of the whistling deformity, (4) a natural-looking mustache, (5) formation of a pout, and (6) psychological benefits. Good results have been obtained with this method. The disadvantage of this method is the maxillary retardation. However, this does not occur in adults and can be corrected easily in children.
A very rare case of supernumerary nostril is reported. This case is different from previously reported cases, because this accessory nostril was located nearer the nasal septum than the natural nostril and its opening was on the same level as the natural one. Although its cause and development are only speculative due to the small number of reported cases, a new hypothesis is proposed and discussed, since our findings are contradictory to previous literature.
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The results of a cleft lip operation are checked from the anterior, the profile, and the caudal views and even if the deformities are minimal, for aesthetic reasons they should be repaired. Philtrum length, philtrum shape, philtrum depth, nasolabial triangular area, vermilion thickness, Cupid's bow peak, horizontal upper lip groove, vermilion border, alar size, depth of alar groove, nasal deviation, nostril shape, nasal tip, columella height, sill shape, columella width, and facial balance of the anterior, profile, and caudal views are used as aesthetic checkpoints for the results of a cleft lip operation. If deformities are found, the aesthetic plastic surgeon should repair them to achieve a more satisfactory result. In addition, augmentation rhinoplasty, augmentation mentoplasty, or other craniofacial surgery may be performed.
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About 90% of blepharoplasties performed in Japan include the double eyelid procedure. The reasons for the popularity of this procedure relate to changing concepts of beauty among the Japanese people. Facial anatomy contributes to the appearance of sleepiness and lethargy in the flat, monotone Japanese face. The narrower eye opening does not allow for the maximum viewing of the cornea. The shortened lateral canthus presents a facial balance that is not considered as attractive as one with an extended lateral canthus. The double eyelid procedure corrects these features, producing a face that is considered more beautiful.
Among Caucasians, augmentation malar plasty is occasionally performed, but, most often Orientals complain of the prominent zygoma and want an oval face. The procedure of the reduction malar plasty is not reported here. Instead, this article discusses the authors' method of reduction malar plasty and presents several cases.
The cleft lip nose is a combination of various deformities, which should be considered in relation to the shape of the whole face. This paper deals with (1) the characteristics of the cleft lip nose; (2) time of the operation; (3) primary operative procedure; (4) secondary operative procedure; and (5) aesthetic operation for the cleft lip nose.
The technique of rhytidectomy used by the authors for the oriental face is explained. The main points of this operative procedure are: 1) the incision line is designed before the operation, 2) subcutaneous undermining is easy, 3) the key sutures are done between the auricular cartilage and the cheek skin to prevent wide scars and, 4) the special incision lines are designed to prevent the downward deformation of the earlobe. This paper also discusses the anatomical differences between Japanese and Caucasian rhytidectomy.