掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s00595-022-02608-2

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その他リンク： https://link.springer.com/article/10.1007/s00595-022-02608-2/fulltext.html

記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

序論/目的:形成外科において他科と共同で行うチームサージャリーは重要な分野であるが、その症例の多くは他科入院であるため、病院経営に対する形成外科の経済的貢献度は明らかになりにくい。チームサージャリーにおける形成外科の貢献度を明らかにすべく、他科共同手術の検討を行い、新型コロナウイルス感染症(以下、COVID-19)が及ぼした影響について考察した。方法:2017～2020年度の4年間に手術に協力した他科入院手術の検討を行った。結果:入院科はCOVID-19前では耳鼻咽喉科(31.4%)が最多であったが、COVID-19後では救急科(38.3%)が最多であった。COVID-19前後で形成外科入院総手術点数は減少したが、他科共同手術の形成外科手術点数は増加した。形成外科が関与した総手術点数は変化がなかった。結論:チームサージャリーにおける形成外科の貢献度とCOVID-19による影響が明らかにされた。幅広い領域において手術に協力することで、社会情勢や医療体制による影響を抑えられることが示された。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本創傷外科学会  

65歳女性。幼少期に受傷した熱傷に伴う仙骨部熱傷瘢痕に、数十年経過したのち仙骨浸潤を伴う有棘細胞癌が生じた。治療目的で当科へ紹介となり、初診2ヵ月後に腫瘍と仙骨合併切除、有茎大臀筋弁による再建術が施行された。その結果、術後11ヵ月経過現在、局所再発は認めず、自力歩行や自転車乗車が可能である。

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記述言語：日本語   出版者・発行元：(一社)日本創傷外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

序論/目的:形成外科において他科と共同で行うチームサージャリーは重要な分野であるが、その症例の多くは他科入院であるため、病院経営に対する形成外科の経済的貢献度は明らかになりにくい。チームサージャリーにおける形成外科の貢献度を明らかにすべく、他科共同手術の検討を行い、新型コロナウイルス感染症(以下、COVID-19)が及ぼした影響について考察した。方法:2017〜2020年度の4年間に手術に協力した他科入院手術の検討を行った。結果:入院科はCOVID-19前では耳鼻咽喉科(31.4%)が最多であったが、COVID-19後では救急科(38.3%)が最多であった。COVID-19前後で形成外科入院総手術点数は減少したが、他科共同手術の形成外科手術点数は増加した。形成外科が関与した総手術点数は変化がなかった。結論:チームサージャリーにおける形成外科の貢献度とCOVID-19による影響が明らかにされた。幅広い領域において手術に協力することで、社会情勢や医療体制による影響を抑えられることが示された。(著者抄録)

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記述言語：日本語   出版者・発行元：日本リンパ学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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担当区分：責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.ajoms.2021.08.001

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s00595-021-02283-9

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その他リンク： https://link.springer.com/article/10.1007/s00595-021-02283-9/fulltext.html

記述言語：日本語   出版者・発行元：(一社)日本熱傷学会  

症例は76歳,女性.意識障害をきたし自宅の石油暖房機の前で倒れて頭部から頬部に熱傷を受傷した.初診時,左頭部に白色壊死を伴う14×11cm大のIII度熱傷を認めた.受傷後2日目の初回デブリードマンにより頭蓋骨露出を認めたが,周囲の帽状腱膜および骨膜は温存し人工真皮を移植した.露出した頭蓋骨,周囲の帽状腱膜および骨膜も壊死にいたり,広範囲に頭蓋骨が露出した.そのため受傷後17日目に良好な出血が得られるまで頭蓋骨外板を削り,遊離広背筋弁および筋弁上への網状植皮により再建した.熱傷深度が深く広範囲に頭蓋骨が露出した場合は,外板を削って肉芽増生後に植皮を行う方法は従来から行われてきたが,治癒まで長期間を要する.早期に血流の豊富な筋弁で被覆する方法は,露出骨の壊死の進行や感染を制御できる有用な再建法と考えられる.(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01220&link_issn=&doc_id=20210917280006&doc_link_id=10.34366%2Fjburn.47.3_114&url=https%3A%2F%2Fdoi.org%2F10.34366%2Fjburn.47.3_114&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

記述言語：日本語   出版者・発行元：(株)全日本病院出版会  

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記述言語：日本語   出版者・発行元：日本リンパ学会  

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記述言語：日本語   出版者・発行元：日本リンパ学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NIHON UNIV, SCHOOL DENTISTRY  

This study aimed to determine the appropriate treatment methods and evaluate associated factors by comparing nonoperative treatment alone with a combination of both nonoperative and surgical treatment in 34 patients with mandibular osteoradionecrosis (mORN). The associated cure factors were analyzed by Cox regression. Propensity scores were calculated from factors that were not significant in the univariate analysis and used as covariates in the multivariate analysis. The cure rate among patients who received nonoperative and surgical treatment was higher than that observed with nonoperative treatment alone. Only the treatment method was associated with cure in both univariate and multivariate analyses.

DOI： 10.2334/josnusd.21-0154

Web of Science

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Mesenchymal stem cells or their conditioned medium improve chronic wound healing, and their effect is enhanced by hypoxia. Diabetic foot ulcers are chronic wounds characterized by abnormal and delayed healing, which frequently require amputation. The authors evaluated the effect of topical application of conditioned medium from hypoxically cultured amnion-derived mesenchymal stem cells on wound healing in diabetic mice. METHODS: Amnion-derived mesenchymal stem cells were cultured under 21% oxygen to prepare normoxic conditioned medium and under 1% oxygen to prepare hypoxic conditioned medium. Hydrogels containing standard medium, normoxic conditioned medium, or hypoxic conditioned medium were topically applied to excisional wounds of mice with streptozotocin-induced diabetes. Ulcer tissues were harvested on day 9; immunohistochemical and quantitative polymerase chain reaction analyses were performed to analyze angiogenesis, inflammatory cell infiltration, and expression levels of inflammation-related genes. RESULTS: Hypoxic conditioned medium significantly enhanced wound closure, increased capillary density and epithelization, and reduced macrophage infiltration. It also tended to reduce the infiltration of neutrophils and enhance the infiltration of regulatory T cells; it showed a tendency to downregulate the expression of the inflammation-related genes interleukin-1β, interleukin-6, chemokine ligand 1, and chemokine ligand 2. Normoxic conditioned medium exhibited similar effects, although they were of lesser magnitude than those of hypoxic conditioned medium. CONCLUSIONS: Hydrogels containing hypoxically cultured, amnion-derived mesenchymal stem cell conditioned medium accelerated wound healing in diabetic mice by enhancing angiogenesis, accelerating epithelization, and suppressing inflammation. Therefore, topical application of amnion mesenchymal stem cell-derived hypoxic conditioned medium could be a novel treatment for diabetic foot ulcers.

DOI： 10.1097/PRS.0000000000007993

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本熱傷学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.burnso.2020.09.001

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担当区分：筆頭著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: In critical limb ischaemia (CLI), first-line therapy is revascularisation, but alternative treatment options are needed in certain cases. Maggot debridement therapy (MDT) is historically considered to be contraindicated in ischaemic ulcers. Wound care in patients with CLI is becoming increasingly diverse with the development of novel revascularisation strategies; therefore, CLI now needs to be reconsidered as an indication for MDT. METHOD: We retrospectively reviewed five legs with CLI (five male, one female) treated with MDT between January 2013 and December 2017. Changes in skin perfusion pressure (SPP) around the ulcer before and after MDT were evaluated. One or two cycles of MDT were performed (eight in total). We also evaluated the proportion of necrotic tissue in the ulcer and the presence of exposed necrotic bone. The proportion of necrotic tissue in the ulcer was classified as NT 1+ (<25%), NT 2+ (25-50%), NT 3+ (50-75%) or NT 4+ (>75%). RESULTS: When the proportion of necrotic tissue was >50%, with no exposed necrotic bone in the wound, an increase in SPP was observed after five (62.5%) of eight cycles of MDT. And with a proportion of necrotic tissue of <25% and/or exposed necrotic bone in the wound, a decrease in SPP was observed after three (37.5%) of eight cycles. Wound healing was accelerated in the presence of increased SPP. CONCLUSION: Effective MDT with increased SPP requires an ulcerative state of necrotic tissue grade > NT 3+, with no exposed necrotic bone.

DOI： 10.12968/jowc.2020.29.Sup12.S28

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01997&link_issn=&doc_id=20210114320001&doc_link_id=10.32154%2Fjjscmfs.36.4_149&url=https%3A%2F%2Fdoi.org%2F10.32154%2Fjjscmfs.36.4_149&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Recurrence rates of keloids have generally been reported at one time point. However, the longer the duration after treatment, the greater the likelihood that such lesions will recur. In this study, we analysed the time to recurrence during long-term follow-up. MATERIAL AND METHODS: We retrospectively reviewed recurrence-free interval in 52 patients with keloid (age 8-79 years) who had been treated between June 2006 and January 2011 using a standardised protocol developed by our group. RESULTS: Mean duration of follow-up was 37.5 (range, 7-120) months in patients with keloid. Kaplan-Meier survival curves revealed a statistically significant difference in recurrence-free interval between ear keloids and keloids excluding ear keloids. Recurrence rate for keloids was high in the first 2 years after treatment. CONCLUSIONS: Kaplan-Meier analysis was useful for understanding the tendency of recurrence of keloids after treatment using a standardised protocol.

DOI： 10.1016/j.jtv.2020.11.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NLM (Medline)  

The purpose of this retrospective study was to compare outcomes of cleft palate repair in patients with non-syndromic Pierre Robin sequence (NS-PRS) versus those with non-syndromic isolated cleft palate (NS-ICP). Pierre Robin sequence (PRS) was defined as a diagnosis of the triad of microretrognathia, glossoptosis, and cleft palate, and the severity of PRS was assessed based on the presence of respiratory and feeding problems. All patients underwent palatoplasty between January 2000 and December 2011. The authors examined age at palatoplasty, type of cleft palate, fistula rate, velopharyngeal (VP) function, nasal emission, hypernasality, and need for secondary speech surgery, in addition to PRS severity in the NS-PRS patients. A total of 15 NS-PRS patients and 40 NS-ICP patients were reviewed. The incidence of VP dysfunction, nasal emission, hypernasality, and secondary speech surgery was not significantly different between the NS-PRS patients and NS-ICP patients. Age at palatoplasty was significantly different between the 2 groups (P = 0.012) but type of CP was not (P = 1.00). Only 2 NS-PRS patients were classified as category III (severe), and all of the NS-PRS patients who had VP insufficiency were classified as PRS severity category I (not severe). The findings of this study indicate that NS-PRS patients may not have worse outcomes than NS-ICP patients.

DOI： 10.1097/SCS.0000000000006672

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The purpose of this retrospective study was to compare outcomes of cleft palate repair in patients with non-syndromic Pierre Robin sequence (NS-PRS) versus those with non-syndromic isolated cleft palate (NS-ICP). Pierre Robin sequence (PRS) was defined as a diagnosis of the triad of microretrognathia, glossoptosis, and cleft palate, and the severity of PRS was assessed based on the presence of respiratory and feeding problems. All patients underwent palatoplasty between January 2000 and December 2011. The authors examined age at palatoplasty, type of cleft palate, fistula rate, velopharyngeal (VP) function, nasal emission, hypernasality, and need for secondary speech surgery, in addition to PRS severity in the NS-PRS patients. A total of 15 NS-PRS patients and 40 NS-ICP patients were reviewed. The incidence of VP dysfunction, nasal emission, hypernasality, and secondary speech surgery was not significantly different between the NS-PRS patients and NS-ICP patients. Age at palatoplasty was significantly different between the 2 groups (P = 0.012) but type of CP was not (P = 1.00). Only 2 NS-PRS patients were classified as category III (severe), and all of the NS-PRS patients who had VP insufficiency were classified as PRS severity category I (not severe). The findings of this study indicate that NS-PRS patients may not have worse outcomes than NS-ICP patients.

DOI： 10.1097/SCS.0000000000006672

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NLM (Medline)  

Infantile hemangiomas arising in the palate are rare. The authors describe a case of ulcerated infantile hemangioma of the hard palate with feeding difficulty. To our knowledge, this is the first reported case of immunohistochemically diagnosed palatal infantile hemangioma successfully treated using oral propranolol.

DOI： 10.1097/SCS.0000000000006666

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記述言語：日本語   出版者・発行元：(株)全日本病院出版会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Ovid Technologies (Wolters Kluwer Health)  

DOI： 10.1097/scs.0000000000006666

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：英語   出版者・発行元：(一社)日本創傷外科学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Society for Surgical Wound Care  

DOI： 10.36748/ijswc.1.1_20

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Society for Surgical Wound Care  

DOI： 10.36748/ijswc.1.2_47

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記述言語：英語  

DOI： 10.1111/1346-8138.15001

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DOI： 10.1097/SCS.0000000000005944

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

4歳女児。側頭骨内腫瘍による右顔面神経の圧迫が原因と思われる先天性顔面神経麻痺に対して1歳半時に右顔面神経減荷術と腫瘍摘出術が行われ、術後は一時的に改善したが、3歳時に不全麻痺と診断された。4歳で紹介受診し、顔面神経刺激での誘発筋電図で一部の患側表情筋に誘発電位を認めたため、ネットワーク型神経再建の適応と判断して手術を行った。右大耳介神経を採取して右舌下神経と右顔面神経との間にクロスリンク型に移植し、術後合併症を認めることなく経過したが、術後9年で表情筋の回復は認めず、改善が得られなかった最大の理由として発症から4年以上経過していることが考えられた。

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01997&link_issn=&doc_id=20191017250004&doc_link_id=10.32154%2Fjjscmfs.35.3_84&url=https%3A%2F%2Fdoi.org%2F10.32154%2Fjjscmfs.35.3_84&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Oculo-auriculo-fronto-nasal syndrome (OAFNS) is a rare anomaly characterized by features overlapping those of frontonasal dysplasia (FND) and the oculo-auriculo-vertebral spectrum (OAVS).1 The FND features malformation of frontonasal process-derived structures, characterized by anomalies in the central portion of the face. The OAVS is characterized by developmental anomalies of the first and second pharyngeal arches. The OAFNS is a condition with clinical features of both FND and OAVS. Here, the authors present the case of a male with OAFNS who not only exhibited typical OAFNS symptoms but also a dysplastic bony structure that bridged the anterior nasal spine and inferior nasal bones, and unilateral type 3 Duane retraction syndrome (absence of right-eye abduction). Abnormal nasal bones are characteristic of OAFNS; such abnormalities are absent from FND and OAVS. The authors reduced the dysplastic nasal bony structure via open external rhinoplasty, followed by lateral nasal osteotomy when he was 16 years of age. The nasal dorsum appeared natural after surgery and he was satisfied with the result.

DOI： 10.1097/SCS.0000000000005636

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.bjoms.2019.05.014

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記述言語：日本語   出版者・発行元：市立函館病院  

症例は70歳男性で,右下腿難治性潰瘍にて外来フォロー中に,その創部に蛆が群がっている場合に遭遇した.創傷部蠅蛆症はハエが生息する環境下で開放創が放置された場合にみられ,社会経済的に劣悪な状況下や,精神障害や自己ネグレクトなどがあると生じることがある.本症例ではゴミ屋敷で起居する環境要因とそれを許容している精神状態に因るところが大きいと思われた.(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01247&link_issn=&doc_id=20191112440005&doc_link_id=http%3A%2F%2Fid.nii.ac.jp%2F1599%2F00016423%2F&url=http%3A%2F%2Fid.nii.ac.jp%2F1599%2F00016423%2F&type=%8ED%96y%88%E3%89%C8%91%E5%8Aw%81F%8ED%96y%88%E3%89%C8%91%E5%8Aw%8Aw%8Fp%8B%40%8A%D6%83%8A%83%7C%83W%83g%83%8A_ikor&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80183_3.gif

記述言語：日本語   出版者・発行元：日本臨床皮膚外科学会  

Facklamia hominis(以下F.hominis)は、Facklamia属に分類される6つの細菌の一つであり、1997年にCollinsらにより最初の報告がなされたグラム陽性通性嫌気性球菌である。Facklamia属の細菌が引き起こしたヒトの感染症は、2005年に英国で最初の報告がなされてから13例を数えるのみである。今回、当院で53歳の女性の後頸部瘢痕に生じた膿瘍の膿汁より、F.hominisが検出された。本邦でFacklamia属の細菌が検出されたヒトの報告は、感染性心内膜炎の1例しかなされていない。細菌の分析方法の進歩により、それまで判別できなかったものが遺伝子レベルで解析できるようになったためだと思われた。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J04088&link_issn=&doc_id=20190710590005&doc_link_id=%2Fce4skins%2F2019%2F002802%2F007%2F0108-0111%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fce4skins%2F2019%2F002802%2F007%2F0108-0111%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s00266-019-01321-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1002/jso.25365

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1002/micr.30394

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jid.2018.07.044

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s10103-019-02753-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/SCS.0000000000004959

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

There has been a long-standing need for guidelines on the diagnosis and treatment of keloids and hypertrophic scars that are based on an understanding of the pathomechanisms that underlie these skin fibrotic diseases. This is particularly true for clinicians who deal with Asian and African patients because these ethnicities are highly prone to these diseases. By contrast, Caucasians are less likely to develop keloids and hypertrophic scars, and if they do, the scars tend not to be severe. This ethnic disparity also means that countries vary in terms of their differential diagnostic algorithms. The lack of clear treatment guidelines also means that primary care physicians are currently applying a hotchpotch of treatments, with uneven outcomes. To overcome these issues, the Japan Scar Workshop (JSW) has created a tool that allows clinicians to objectively diagnose and distinguish between keloids, hypertrophic scars, and mature scars. This tool is called the JSW Scar Scale (JSS) and it involves scoring the risk factors of the individual patients and the affected areas. The tool is simple and easy to use. As a result, even physicians who are not accustomed to keloids and hypertrophic scars can easily diagnose them and judge their severity. The JSW has also established a committee that, in cooperation with outside experts in various fields, has prepared a Consensus Document on keloid and hypertrophic scar treatment guidelines. These guidelines are simple and will allow even inexperienced clinicians to choose the most appropriate treatment strategy. The Consensus Document is provided in this article. It describes (1) the diagnostic algorithm for pathological scars and how to differentiate them from clinically similar benign and malignant tumors, (2) the general treatment algorithms for keloids and hypertrophic scars at different medical facilities, (3) the rationale behind each treatment for keloids and hypertrophic scars, and (4) the body site-specific treatment protocols for these scars. We believe that this Consensus Document will be helpful for physicians from all over the world who treat keloids and hypertrophic scars.

DOI： 10.1186/s41038-019-0175-y

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：日本下肢救済・足病学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

序論:チームサージャリーにおける形成外科の貢献度は明らかになりにくい。方法:2007〜2016年度に手術に協力した他科入院手術を前期と後期に分け、入院料、手術点数、形成外科の手術時間、人数を検討した。結果:他科共同手術は年平均65.5例(前期63.0例、後期68.0例)、入院科は耳鼻咽喉科25.2%、口腔外科・口腔内科23.8%が多くを占めた。他科共同手術における形成外科手術点数は、総手術点数の年平均58.1%(前期55.0%、後期61.1%)を占め、これは形成外科入院総手術点数の年平均33.9%(前期32.3%、後期35.5%)に相当した。他科共同手術における形成外科手術時間は、年平均294時間(4.5時間/件)、手術に参加した形成外科医は、年平均238人(3.6人/件)であった。結論:本検討によりチームサージャリーにおける形成外科の貢献度、形成外科におけるチームサージャリーの重要性が増していることが判明した。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

序論:チームサージャリーにおける形成外科の貢献度は明らかになりにくい。方法:2007〜2016年度に手術に協力した他科入院手術を前期と後期に分け、入院料、手術点数、形成外科の手術時間、人数を検討した。結果:他科共同手術は年平均65.5例(前期63.0例、後期68.0例)、入院科は耳鼻咽喉科25.2%、口腔外科・口腔内科23.8%が多くを占めた。他科共同手術における形成外科手術点数は、総手術点数の年平均58.1%(前期55.0%、後期61.1%)を占め、これは形成外科入院総手術点数の年平均33.9%(前期32.3%、後期35.5%)に相当した。他科共同手術における形成外科手術時間は、年平均294時間(4.5時間/件)、手術に参加した形成外科医は、年平均238人(3.6人/件)であった。結論:本検討によりチームサージャリーにおける形成外科の貢献度、形成外科におけるチームサージャリーの重要性が増していることが判明した。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Mary Ann Liebert Inc.  

Background: Lymph node transplantation is being increasingly recognized as a method of reconstruction of the lymphatic system for the treatment of lymphedema. However, the mechanisms regulating the connections between the lymphatic vessels and the lymph nodes remain poorly understood. The objective of this study was to examine whether removal of a popliteal lymph node (PLN) could result in rerouting of lymph flow and whether a single transplanted nonvascularized lymph node could reconnect with a lymphatic vessel and restore lymph flow. Methods and Results: Thirty-six mice were allocated to undergo resection of a PLN alone (group 1) or a transplanted lymph node after resection of a PLN (group 2). Changes in lymph flow were observed using indocyanine green dye. The ability of the transplanted lymph node to reconnect with the lymphatic vessels was examined by fluorescein isothiocyanate (FITC)-dextran and immunohistochemical staining. In group 1, the flow of lymph was redirected to an inguinal lymph node (ILN) in 8 of 18 mice and continued to drain to the PLN in 10 mice. In group 2, the lymph continued to drain normally after removal of the PLN, and was also directed to an ILN in two mice. FITC-dextran demonstrated continuity of the transplanted PLN and the lymphatic vessels. Immunohistochemical staining showed that T cell and B cell populations in the transplanted lymph node were preserved. Conclusion: Lymphatic flow was rerouted after lymph node resection. A transplanted lymph node can be made viable with normal lymph flow by reconnecting the transplanted lymph node to a lymphatic vessel.

DOI： 10.1089/lrb.2016.0070

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1002/ijc.31414

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

4ヵ月女児。生下時より軟口蓋裂、舌裂、頬小帯の形成、両手第2・3指間の合指症を認め、頭位は生下時36.0cmから1週間に0.6cm拡大を呈して小泉門の膨隆を認めた。顔面には多発する小丘疹を認めApert症候群を疑ったが、生後6ヵ月時の頭部CT・MRIで脳梁の低形成、多房性の半球間裂嚢胞を認めた。頭蓋縫合の早期癒合は認めず、小泉門の膨隆および脳圧亢進は嚢胞内への嚢液貯留によるものであり、Apert症候群は否定された。臨床所見、画像所見から総合的にOral-facial-digital syndrome type Iと診断し、生後7ヵ月時にクモ膜嚢胞-腹腔シャント術を施行し、1歳11ヵ月時にFurlow法による軟口蓋形成術を施行した。6歳時に咽頭弁形成術を施行し、経過観察中である。

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Purpose: This study evaluated short-term and long-term changes in bone height after mandibular reconstruction using an osteotomized fibula graft, with the aim of identifying factors associated with atrophy of the graft in an elderly population.
Patients and Methods: This retrospective study involved patients who underwent mandibular reconstruction using a free vascularized fibula graft from 2005 through 2015 and had at least 12 months of follow-up. Postoperative panoramic radiographs were used to measure bone height at standardized locations on each segment of the graft at 1 year postoperatively and at later follow-up.
Results: The sample was composed of 30 patients (15 men, 15 women; mean age, 62.6 years; age range, 50 to 80 years). According to the HCL classification (H, hemimandibular segment including the condyle; C, central segment including both mandibular canine teeth; L, lateral segment without the condyle), mandibular defect types were L (n = 19), LC (n = 7), LCL (n = 3), and H (n = 1). There were 0 to 3 segmental osteotomies with the fibula graft. None of the patients received an osseointegrated dental implant during a mean follow-up of 4.0 years (range, 1.5 to 9.7 yr). All patients underwent reconstruction of the mandibular body, 10 of whom also underwent reconstruction of the mandibular ramus. Atrophy of the fibula graft was observed in 9.9 and 15.0% of the body segment and 5.9 and 6.6% of the ramal segment at 1 year postoperatively and at later follow up, respectively. Graft hypertrophy occurred in the ramal segment in 2 patients. Multivariate analysis showed a significantly higher rate of graft atrophy in women than in men at later follow-up (P = .033).
Conclusions: Fibula grafts showed long-term stability, and in 2 cases even a gain in bone height, in this elderly population. Female gender was identified as a risk factor for atrophy of the fibula bone graft in the body segment of the reconstructed mandible. (c) 2017 American Association of Oral and Maxillofacial Surgeons

DOI： 10.1016/j.joms.2017.05.011

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記述言語：日本語   出版者・発行元：(一社)日本熱傷学会  

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記述言語：日本語   出版者・発行元：市立函館病院  

49歳男性。睫毛貧毛症に対しビマトプロストによるハーフサイドテストを実施した。右睫毛に対しビマトプロストを1日1回、20週間使用した。その結果、使用開始8週目の時点で使用側の上下睫毛は対照側よりも長く太くなり、この状況は使用開始20週間たった時点でも同様であり、その有効性が示された。尚、本治療薬の使用中に疼痛やそう痒感などの異常はみられず、安全面においても問題はないと考えられた。

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01247&link_issn=&doc_id=20171124590017&doc_link_id=http%3A%2F%2Fir.cc.sapmed.ac.jp%2Fdspace%2Fhandle%2F123456789%2F7095&url=http%3A%2F%2Fir.cc.sapmed.ac.jp%2Fdspace%2Fhandle%2F123456789%2F7095&type=%8ED%96y%88%E3%89%C8%91%E5%8Aw%81F%8ED%96y%88%E3%89%C8%91%E5%8Aw%8Aw%8Fp%8B%40%8A%D6%83%8A%83%7C%83W%83g%83%8A_ikor&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80183_3.gif

記述言語：日本語   出版者・発行元：日本臨床皮膚外科学会  

医療関連機器圧迫創傷(MDRPU)症例37例48ヶ所を対象に診療録を後ろ向きに検討し、データをベストプラクティス医療関連機器圧迫創傷の予防と管理(BP)に記載されている疫学の一般病院と比較した。その結果、年齢は75〜84歳が最多で、次いで65歳〜74歳であった。原疾患は外傷が最多で、次いで悪性新生物であった。発生部位は鼻が最多で、次いで下肢であった。深さは真皮までの損傷が約4割を占めた。原因となった医療関連機器は、医療用弾性ストッキングと非侵襲的陽圧換気療法マスクが最多であった。BPと対比すると、原疾患(BPでは骨関節疾患が最多で次いで呼吸器疾患)、発生部位(BPでは足が最多で次いで下肢)、原因となった医療関連機器(BPではギプス、シーネが最多で次いで医療用弾性ストッキング)に違いがみられた。

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Early excision and skin grafting is the principle treatment for a burned hand although there are occasions when it cannot be done such as severe general condition, delayed consultation, and the lack of a definitive assessment of burn depth. This study analyzes the factors that affected function after a delayed excision and skin graft for hands with a deep dermal burn. This study retrospectively evaluated 43 burned hands that required a delayed excision and split-thickness skin graft on the dorsal side. Cases were required to only have split-thickness skin grafting from the dorsum of the hand and fingers distally to at least the proximal interphalangeal joint at least 8 days after the injury. The hands were divided into two functional categories: Functional category A, normal or nearly normal joint movements, and functional category B, abnormal joint movements. Demographic data were assessed statistically by a univariate analysis following a multiple regression analysis by a stepwise selection. A significant difference was observed between the groups in the number of days from grafting to complete wound healing of the graft site and with or without an escharotomy in the analysis. These parameters were statistically significant predictors of functional category B. The functional outcome of a burned hand after a delayed excision and split-thickness skin graft on the dorsal side became degraded depending on the number of days from grafting to complete wound healing. Cases that underwent an escharotomy also showed deterioration in function.

DOI： 10.1097/BCR.0000000000000505

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Background The purpose of this study was to evaluate the superficial lymph drainage patterns of primary skin cancers of the head arising from the occipital or parietal region.
Method The dominant patterns of lymph drainage were retrospectively reviewed in eight patients aged 36-85 years with skin cancers in the occipital or parietal region in whom sentinel lymph node biopsy or lymph node dissection had been performed at Hokkaido University Hospital between January 1981 and December 2015.
Results Lymph drainage was mainly to the occipital (6/8, 75%), level II (5/8, 63%), and level V lymph nodes (5/8, 63%). Of the six patients with drainage to the occipital lymph nodes, four (67%) also had drainage to level V nodes.
Conclusions The dominant lymph drainage pattern in patients with skin cancer arising from the occipital or parietal region was to the occipital, level II, and level V lymph nodes. Further, lymph tended to drain directly from the occipital region to the level V lymph nodes.

DOI： 10.1007/s10147-017-1121-2

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記述言語：英語   出版者・発行元：SPRINGER JAPAN KK  

Background Past studies showed that integumentectomy and incontinuity could be effective procedures in the surgical management of melanoma patients. The present study reports on the historical background of these procedures. In addition, we analyze the ICG assisted integumentectomy and incontinuity techniques and algorithms that we had created when performing this procedure.
Method In accordance with our algorithm, we performed ICG assisted integumentectomy/incontinuity procedures on 17 patients with stage III melanomas between 2008 and 2016. We also investigated the locoregional recurrence rate in a control group comprising 60 patients at stage III without using the algorithm.
Results The former group exhibited a tendency of locoregional recurrence rate suppression. Melanoma cells in the dissected intervening tissue were microscopically identified in 2 out of 17 cases.
Conclusions Our ICG assisted integumentectomy or incontinuity procedures could be effective in controlling locoregional recurrence rates in melanoma cases. Moreover, our method can be generally applied because the dissection is only performed within the lymphatic pathway region identified using indocyanine green.

DOI： 10.1007/s10147-016-1085-7

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Full-thickness defects of the entire nasal ala, including the rim, can be challenging to reconstruct. A forehead flap may provide a more imperceptible and natural-appearing reconstructed nasal ala. Previously, many authors have insisted adding cartilaginous infrastructural support for an entire, full-thickness defect to keep the postoperative alar structure symmetrical. They finally use a forehead flap after thinning of the distal covering portion subcutaneously, possibly for a Caucasian-type nasal ala. However, Asian skin has a thicker and more compact dermis than that of Caucasian skin, and the Asian ala is rounder and thicker. There may be another approach for an Asian-type nasal ala. The authors propose the possibility of nasal alar reconstruction for an entire, full-thickness defect in Asians using a forehead flap without structural support. Six patients with entire full-thickness nasal alar defects treated with full-thickness forehead flaps above the periosteum without structural support were reviewed. Five patients demonstrated esthetically good to excellent outcomes in color, texture, and symmetry. Their nasal linings were reconstructed using mucoperiosteal flaps or mucosal grafts. One patient treated with a nasal lining using a local flap showed a fair result esthetically. Asians forehead above the periosteum has adequate thickness and supportability to reconstruct the entire full-thickness nasal ala in Asians. No cartilage support is necessary.

DOI： 10.1097/SCS.0000000000003389

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

口腔癌の血管柄付遊離皮弁再建術後に生じた中心静脈カテーテル関連深部静脈血栓症を2例経験したので報告するとともに、北海道大学病院では2014年7月から「歯科医師のための血栓発見時の対応マニュアル」の運用を行っているので紹介する。症例1:60歳男性。右口底癌cT4aN1M0の診断で、2010年5月に右頸部郭清術、口底悪性腫瘍切除術、前外側大腿皮弁による再建術を施行した。麻酔の導入時に大腿静脈より中心静脈カテーテルが挿入され、術後5日目で抜去した。術前の4月の上部消化管内視鏡検査で早期胃癌が発見されたため、内視鏡的粘膜剥離術を予定し、8月に腹部造影CTを撮像したところ、下大静脈内に7cm長の血栓が認められた。深部静脈血栓症の診断のもと循環器内科の指示でワルファリンカリウムの内服を開始した。2週後の腹部造影CTで下大静脈血栓の縮小を認め、2ヵ月後に血栓の消失が確認された。症例2:69歳女性。左舌癌cT2N0M0の診断で、2014年2月に左頸部郭清術、舌亜全摘術、前外側大腿皮弁による再建術を施行した。麻酔の導入時に大腿静脈より中心静脈カテーテルが挿入され、術後7日目で抜去した。術後1週間でプロスタグランジンE1製剤が原因と考えられる薬剤性肝機能障害を認めたため、腹部超音波検査、腹部造影CTを施行した。その際に、右大腿静脈、右総腸骨静脈〜下大静脈にかけて血栓形成が発見され、深部静脈血栓症の診断のもとヘパリンナトリウムを開始した。1週間後の腹部造影CTにて血栓の消失が確認された。(著者抄録)

DOI： 10.5843/jsot.29.1

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記述言語：日本語   出版者・発行元：市立函館病院  

53歳男性。仕事中に右手を機械に挟まれ受傷し、直ちに救急搬送となった。搬入時、母指から環指にかけて広範囲の高度挫滅創を認め、全身麻酔下で合計8回の手術を施行した。第1病日には1回目手術として洗浄、デブリードマン、ピンニング、腹壁皮弁作成術を行い、第15病日に2回目手術としてデブリードマン、皮弁切り離し、第27病日に3回目手術として2度目の皮弁切り離し、分層植皮術を行った。第48病日は第4回手術としてデブリードマン、指切り離し、2度目の分層植皮術、第274病日は第5回目手術として2度目の指切り離し、指間形成術、動脈皮弁術を、第289病日は第6回目手術として全層植皮術を行った。以後、第461病日に第7回目手術として2度目の形成術、除脂肪術を行い、第644病日に第8回目手術として関節授動術、2度目の除脂肪術、瘻孔閉鎖術を行った。その結果、第785病日の時点で中指掌側尺側より骨露出部を認めるが、良好な形態形成が得られている。

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J01247&link_issn=&doc_id=20161129430005&doc_link_id=http%3A%2F%2Fid.nii.ac.jp%2F1599%2F00013924%2F&url=http%3A%2F%2Fid.nii.ac.jp%2F1599%2F00013924%2F&type=%8ED%96y%88%E3%89%C8%91%E5%8Aw%81F%8ED%96y%88%E3%89%C8%91%E5%8Aw%8Aw%8Fp%8B%40%8A%D6%83%8A%83%7C%83W%83g%83%8A_ikor&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80183_3.gif

記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

The authors report a case of an 84-year-old woman with an exposed mandibular plate after reconstruction, which finally healed with combination therapy using vacuum-assisted closure therapy and hyperbaric oxygen therapy. The woman was diagnosed with mucosal carcinoma of the right oral cavity. During reconstruction after segmental excision of the mandible, a titanium plate was selected based on several risk factors. After the operation, the plate became exposed at the center of the chin. A second surgery was deemed inappropriate because of her age, malnutrition, and recurrent aspiration pneumonia. Instead, combination therapy consisting of vacuum-assisted closure therapy and hyperbaric oxygen therapy was initiated, leading to epithelizaion of the wound. Adapt Barrier Rings was effectively used to generate a stable negative pressure at the complicated craniofacial wound. A surgical or conservative approach is chosen as salvage treatment of an exposed plate. In this patient, only conservative treatment involving combination therapy resulted in complete healing of the wound with plate exposure. This patient highlights 2 important clinical issues: combination therapy was effective for an exposed mandibular plate, and a dressing technique using Adapt Barrier Rings enabled stable negative pressure in the craniofacial wound.

DOI： 10.1097/SCS.0000000000002917

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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記述言語：日本語   出版者・発行元：日本臨床皮膚外科学会  

壊死性筋膜炎は重篤な皮膚・軟部組織感染症である。当院で、2009年11月から2015年6月の間に経験した壊死性筋膜炎12症例に関し、診療録を基に後ろ向きに解析を行った。救命し得た7症例(生存群)と救命し得なかった5症例(死亡群)に分け、患者背景、治療経過を調べた。さらに、血液生化学検査による診断補助ツールであるLaboratory Risk Indicator of Necrotizing Fasciitis SCORE(以下LRINEC score)と、年齢や免疫状態による予後推定ツールであるGolger値を算定し、両群間の差異を検討した。その結果、両群間で年齢や搬入から手術までの時間、LRINEC scoreに有意差を認めなかったが、Golger値は両群間で有意差を認めた。LRINEC scoreは壊死性筋膜炎の診断ツールとしては有用であるが予後は反映せず、その予想にはGolger値が有用であると思われた。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J04088&link_issn=&doc_id=20161121540006&doc_link_id=%2Fce4skins%2F2016%2F002503%2F007%2F0156-0158%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fce4skins%2F2016%2F002503%2F007%2F0156-0158%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

The cheek region is the most common site for malignant tumor occurrence and the treatment of malignant skin tumor requires extensive local excision. Many previous reports have covered methods of reconstruction using local flaps for skin defects in the cheek region.
In this article, we describe our experience with a surgical reconstruction using a new flap method for 8 patients with missing tissue in the cheek region. This flap is based on the concept of separately designing the flap with the 3 areas comprising the malar, posterior auricular, and cervical regions. We named the flap containing these 3 regions the malar-posterior auricular-cervico flap. Esthetically satisfactory outcomes were achieved in all cases.
In conclusion, we recommend our malar-posterior auricular-cervico flap to reconstruct the tissue defects of approximately 20 to 40 cm(2) after tumor excision in the cheek region. If preauricular skin is included in the design of this flap, the sideburn can be reconstructed using a part of the nape region with hair.

DOI： 10.1097/SAP.0000000000000575

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Lymphedema is a condition characterized by progressive swelling and adipose deposition that occurs commonly after lymphadenectomy. Recent clinical studies have suggested that the transfer of lymph nodes to the lymphedematous limb can improve lymphatic function. In this report, we investigate dynamic modulation of lymphatic flow and the microscopic changes of lymphatic regeneration using a lymphedema mouse model that was treated with nonvascularized lymph node transplantation. To evaluate the effect of lymph node transplantation in this model, paw volume was measured using a water displacement plethysmometer; an indocyanine green fluorescence-sensitive camera system was used. The improvement of edema was evident in the paw of the transplantation group. The abnormal fluorescence image pattern gradually improved and disappeared 4 weeks postoperatively in the transplantation group. Uptake in the transplanted lymph node was observed 4 weeks postoperatively. This finding suggested that the transplanted lymph node was engrafted. A collateral pathway was observed in the ventral area 1 week postoperatively. The collateral pathway may have contributed to the early improvement of edema. Our findings suggest that lymph node transplantation can restore lymphatic function. This result has important conceptual implications in the treatment of postsurgical lymphedema.

DOI： 10.1097/SAP.0000000000000428

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記述言語：日本語   出版者・発行元：(一社)日本口蓋裂学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Background and aim: Neuregulin-1 is an essential axoglial signal required for peripheral nerve development, and evidence that neuregulin-1 is also required for effective nerve repair is growing. In this study, the effects of neuregulin-1-impregnated gelatin hydrogels on nerve regeneration and functional recovery after anastomosis of the facial nerve were investigated in a rat model of traumatic facial nerve paralysis.
Materials and methods: Twenty-four adult male rats underwent complete resection of the facial nerve trunk, followed by end-to-end anastomosis with epineural sutures. The animals were then randomly allocated to one of three treatment groups (eight rats/group): no additional intervention (Group I), single-shot injection of neuregulin-1 into the epineurium of the facial nerve at the suture sites (Group II), or implantation of a hydrogel impregnated with neuregulin-1 at the injury site (Group III). After surgery, mimetic muscle movements were evaluated weekly. Eight weeks after surgery, the mimetic muscles were injected with a neural tracer (1,10-dioctadecyl-3,3,30,30-tetramethylindocarbocyanin perchlorate, DiI). Retrograde-labeled neurons were counted in the facial nuclei, and facial nerve specimens were stained with toluidine blue for histological examination of axon density.
Results: Group III exhibited significantly faster recovery of mimetic muscle function, a higher density of large-diameter axons (&gt;5 mu m) in the facial nerve, and greater numbers of retrogradely labeled neurons in the ipsilateral facial nucleus compared with Groups I and II.
Conclusions: Continuous release of neuregulin-1 from impregnated gelatin hydrogels can accelerate facial nerve regeneration. (C) 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjps.2015.10.037

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CHURCHILL LIVINGSTONE  

Various techniques have been described for unilateral cleft lip repair. These may be broadly classified into three types of procedure/concept: the straight-line method (SL; Rose-Thompson effect); rotation -advancement (RA; upper-lip Z-plasty); and the triangular flap method (TA; lower-lip Z-plasty). Based on these procedures, cleft lip repair has evolved in recent decades. The cleft lip repair method in our institution has also undergone several changes. However, we have found that further modifications are needed for Asian patients who have wider philtral dimples and columns than Caucasians, while following the principles of the original techniques mentioned above. Here, we have incorporated the advantages of each procedure and propose a refined hybrid operating technique, seeking a more appropriate procedure for Asian patients. To evaluate our new technique, a comparison study was performed to evaluate RA, SL, and our technique.
We have used our new technique to treat 137 consecutive cleft lip cases of all types and degrees of severity, with or without a cleft palate, since 2009. In the time since we adopted the hybrid technique, we have observed improved esthetics of the repaired lip. Our technique demonstrated higher glance impression average scores than RA/SL. (C) 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jcms.2015.09.005

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記述言語：日本語   出版者・発行元：(一社)日本美容外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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DOI： 10.1007/s00405-014-3420-9

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記述言語：日本語   出版者・発行元：(一社)日本熱傷学会  

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記述言語：日本語   出版者・発行元：日本臨床皮膚外科学会  

当科で過去6年間に経験した結核症例10例について検討した。その結果、男4例・女6例、年齢は33〜94歳(平均76.6歳)であった。9例が肺結核で、1例のみが眼瞼結膜の結核腫と結核性頸部リンパ節腫脹であった。形成外科の介入した理由は、褥瘡の治療が6例、腫瘍の精査が2例、皮膚悪性腫瘍の治療が1例、熱傷の治療が1例であった。4例が当院で死亡したが、結核によるものは2例であった。3例が転院し、2例が外来で経過観察中で、外国人労働者であった1例は帰国した。

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本熱傷学会  

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記述言語：日本語   出版者・発行元：(株)医学書院  

＜POINT＞肩甲骨皮弁の歴史を紹介した。肩甲骨皮弁の特徴と適応についてまとめた。肩甲骨皮弁挙上の実際について触れた。肩甲骨皮弁の術後管理と合併症対策について述べた。代表症例を供覧した。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J02122&link_issn=&doc_id=20150619030010&doc_link_id=10.11477%2Fmf.1411200664&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1411200664&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本口蓋裂学会  

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DOI： 10.1055/s-0035-1549284

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記述言語：日本語   出版者・発行元：日本皮膚悪性腫瘍学会  

初発の悪性黒色腫の治療から24年という長期経過後に，新たな原発としての悪性黒色腫が発症した症例を報告する。66歳，男性。42歳時，左胸部の悪性黒色腫の診断で広範囲切除と左腋窩郭清を行い経過良好，年一回の外来通院での経過観察となっていた。66歳の時の定期受診時に，右大腿の黒褐色斑に色調変化を認めたため，生検を施行したところ悪性黒色腫の診断であった。新たな原発の黒色腫として広範囲切除施行，センチネルリンパ節は陰性であったが5年後に鼠径リンパ節転移として再発。リンパ節郭清を行いその後30ヵ月再発なく経過良好である。 多重悪性黒色腫（multiple primary melanoma）の報告の中でも，24年という長期経過観察後の新たなる原発出現の報告は稀である。家族歴もなく，異形母斑の多発の既往もないケースであったが，長期経過観察の中で新たな原発の黒色腫を発症した。悪性黒色腫において，長期経過観察の重要性を示す症例を経験した。

DOI： 10.5227/skincancer.30.223

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その他リンク： http://search.jamas.or.jp/link/ui/2016374189

DOI： 10.3109/23320885.2014.982654

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CHURCHILL LIVINGSTONE  

Tessier cleft types 3 and 4 are both rare craniofacial anomalies. Here we present the first case of a girl born with a combined anomaly of Tessier clefts 3 and 4 with severe bilateral cleft lip, a displaced premaxilla, and three-dimensional underdevelopment of the hard and soft tissues of the maxilla and zygoma. This type of rare facial cleft poses a major operative challenge. Over a period of years, presurgical alveolar molding with an active appliance was followed by seven operations. A satisfactory esthetic outcome was obtained. A multidisciplinary approach to treatment with a plastic surgeon in charge of the operations and an orthodontist in charge of the cleft deformity is essential. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jcms.2014.09.003

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER IRELAND LTD  

Objective: This study was performed to investigate speech outcomes after three different types of palatoplasty for the same cleft type. The objective of this study was to investigate the surgical techniques that are essential for normal speech on the basis of each surgical characteristic.
Methods: Thirty-eight consecutive nonsyndromic patients with unilateral complete cleft of the lip, alveolus, and palate were enrolled in this study. Speech outcomes, i.e., nasal emission, velopharyngeal insufficiency, and malarticulation after one-stage pushback (PB), one-stage modified Furlow (MF), or conventional two-stage MF palatoplasty, were evaluated at 4 (before intensive speech therapy) and 8 (after closure of oronasal fistula/unclosed hard palate) years of age.
Results: Velopharyngeal insufficiency at 4 (and 8) years of age was present in 5.9% (0.0%), 0.0% (0.0%), and 10.0% (10.0%) of patients who underwent one-stage PB, one-stage MF, or two-stage MF palatoplasty, respectively. No significant differences in velopharyngeal function were found among these three groups at 4 and 8 years of age. Malarticulation at 4 years of age was found in 35.3%, 10.0%, and 63.6% of patients who underwent one-stage PB, one-stage MF, and two-stage MF palatoplasty, respectively. Malarticulation at 4 years of age was significantly related to the presence of a fistula/unclosed hard palate (P &lt; 0.01). One-stage MF palatoplasty that was not associated with postoperative oronasal fistula (ONF) showed significantly better results than two-stage MF (P &lt; 0.01). Although the incidences of malarticulation at 8 years of age were decreased in each group compared to at 4 years of age, the incidence was still high in patients treated with two-stage MF (45.5%). On the whole, there was a significant correlation between ONF/unclosed hard palate at 4 years of age and malarticulation at 8 years of age (P &lt; 0.05).
Conclusion: Appropriate muscle sling formation can compensate for a lack of retropositioning of the palate for adequate velopharyngeal closure. Early closure of the whole palate and the absence of a palatal fistula were confirmed to be essential for normal speech. To avoid fistula formation, multilayer repair of the whole palate may be critical. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ijporl.2014.09.021

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記述言語：日本語   出版者・発行元：日本臨床皮膚外科学会  

82歳男。右耳介に腫瘍を生じ、精査希望で当科受診となった。初診時所見で右耳輪の耳甲介舟に向かう面に8×5×4mmのやや硬い腫瘍を認めたため、腫瘍切除し、皮膚欠損部に人工真皮を貼付した。病理組織所見では、ヘマトキシリン・エオジン染色で類円形から卵円形でしばしばくびれを呈する核と弱好酸性の胞体をもつ類円形の異型細胞を認め、びまん性に増生していた。ランゲルハンス細胞肉腫(LCS)と診断し、化学療法を検討したが、患者の希望により、経過観察とした。創部は術後27日目に上皮化を認め、現在も腫瘍の再発は認めなかった。その後、右耳輪切除の2ヵ月後に右側頭部に直径15mmの腫瘍を認めたため腫瘍切除を行った。免疫組織化学染色でCD1a陽性、S-100蛋白で一部陽性を認め、LCSと診断した。患者の希望で追加治療は行わず、経過観察とした。電子顕微鏡でBirbeck顆粒を認めた。現在、腫瘍再発は認めなかった。

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記述言語：日本語   出版者・発行元：日本臨床皮膚外科学会  

当院での銃創の症例を報告する。患者は59歳の男性で、同行者のもっていたライフル銃が暴発し左下腿に被弾した。内側頭側に射入口を、同外側尾側におよそ20×15cmの射出口を認めた。左脛骨粉砕骨折と左腓骨骨端部骨折を認め、深腓骨神経領域に知覚鈍麻が存在した。足趾の底屈は可能だが、背屈は不能であった。左足背動脈の拍動は良好であった。創洗浄、植皮術、骨移植術、筋弁術など7回の全身麻酔下の手術ののち、第371病日に装具をつけて歩行・退院となった。銃創は、銃器の種類、弾丸の種類と数量、被弾場所の3点が損傷を推測し、治療計画を立てるうえで重要だと思われた。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J04088&link_issn=&doc_id=20141110410001&doc_link_id=%2Fce4skins%2F2014%2F002303%2F002%2F0107-0114%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fce4skins%2F2014%2F002303%2F002%2F0107-0114%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J02567&link_issn=&doc_id=20150121400001&doc_link_id=10.11270%2Fjjsrm.27.67&url=https%3A%2F%2Fdoi.org%2F10.11270%2Fjjsrm.27.67&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

DOI： 10.1007/s00595-014-0996-z

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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DOI： 10.1111/exd.12368

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Background The most common site for melanoma occurrence is the cheek region, and the treatment of melanoma requires extensive local excision. This study evaluated factors that influence the selection of reconstructive procedures after excision of a cheek melanoma.
Methods A total of 26 cases (12 with skin grafts, 7 with local flaps, and 7 with free flaps) were included in the study. Factors in the selection of reconstructive procedures were evaluated by examining the size of the skin defects, patient age, and prognosis.
Results Free flaps were frequently used in cases with large areas of skin defect and with thicker melanomas. Skin grafts were used for a wide variety of tumor thicknesses and for older patients with thick melanomas (due to the general condition of the patients). The dividing line of the range of skin defects between local and free flaps was approximately 40 cm(2). Reconstruction procedures had no impact on prognosis.
Conclusions In deciding on a reconstruction procedure after the excision of a cheek melanoma, 3 factors are important: the range of the skin defect, the severity of the melanoma, and the age of the patient.

DOI： 10.1097/SCS.0000000000000397

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Background The objective of this study is to evaluate the lymph drainage from the primary focus to the regional lymph nodes in patients with melanomas of the upper extremity and upper trunk region.
Method The study is a retrospective study of 20 patients with upper extremity melanomas and 14 patients with upper trunk melanomas treated with axillary lymph node dissection (ALND) or sentinel lymph node biopsy at the hospital. ALND was performed in 14 cases. In these cases, 12 were curative dissections and 2 were elective dissections. The dominant lymph drainage patterns from the primary regions were analyzed.
Results Among the upper extremity and upper trunk region melanomas, lymph drainage to Level I was determined in all cases. In these two regions there were no cases of lymph drainage to Level II not passing through Level I. Furthermore, there were no cases where sentinel lymph node or metastasis of the lymph nodes was clearly determined in Level III. Among the upper extremity melanomas, lymph drainages to the cubital (10 %) and mid-arm nodes (5 %) were established. Among the scapular region melanomas, lymph drainages to the supraclavicular nodes (25 %) were determined.
Conclusions There was a dominant lymph drainage pattern of melanomas of the upper extremity and upper trunk region to Level I. No lymph node dissection of Level III in patients with melanomas of the upper extremity and upper trunk region is necessary unless preoperative examination determines a high possibility of metastasis-positive lymph nodes in level III.

DOI： 10.1007/s10147-012-0504-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

In minor-form or microform cleft lip, normal anatomical structures with slight displacement remain and should be used effectively to obtain symmetrical results.
We treated 7 patients with minor-form or microform cleft lip between 2005 and 2009. In all patients, the peak of Cupid bow with a natural curve of the white roll was recognized on the lateral lip. We modified the incision line to maintain the natural curve and obtained a symmetrical and natural-looking Cupid bow.
In this article, we emphasize the importance of preserving the remaining normal structure, particularly the curve of the white roll on the lateral lip, and suggest that the peak of the curve should be defined as Cupid bow peak of the cleft side. Details of our concept for the correction of minor-form or microform cleft lip are also introduced.

DOI： 10.1097/SAP.0b013e3182587215

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Society of Reconstructive Microsurgery  

In this paper, a review of unfavorable head and neck reconstructive cases due to the complication of microvascular anastomosis at our institute is described. Between 2004 and 2014, the total number of head and neck reconstructive cases in which free flaps and microvascular augmentation were performed as team surgery was 239. In this series, 11 cases ( 4.4% ) required secondary surgical salvage due to postoperative thrombosis at the anastomosed site. Finally, 9 flaps failed and the rate of total necrosis of free flaps was 3.8%. Evaluation of the causes and methods of surgical salvage in cases with unfavorable results is very important for future advances and improvements in reconstructive surgery.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Hikikomori, or severe social withdrawal, in Japan's young people has been a prominent public mental health concern since around 2000. A case of skin necrosis in a hikikomori teenager is reported in this article. From the patient's history and the shape of the skin ulcer, we diagnosed her necrotic ulcer was pressure sore, caused by sitting on the toilet seat for a long time. Antibiotic treatment, surgical debridement and skin were performed. The ulcer was healed eight weeks after admission. In future, the incidence that medical staff, not psychiatrists, encounters in hikikomori patients may increase because of the increase of the secondary disease based on hikikomori. The consensus about the causes, diagnosis and therapeutic interventions for hikikomori will be required not only by psychiatrists but also by all of the medical staff now, with urgency. © 2012 Taylor &amp
Francis.

DOI： 10.1080/17542863.2012.685485

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Verlag  

Coagulation disorders can be classified into two types: excessive bleeding and excessive clotting. Furthermore, the severity of the coagulation disorders can vary significantly among patients. We evaluated two relatively rare cases involving factor XIII subunit deficiency and antiphospholipid syndrome (APS) with concomitant systemic lupus erythematosus (SLE) in two patients undergoing flap reconstructions after tumor excision. In the patient with excessive bleeding as a result of a factor XIII subunit deficiency, flap necrosis occurred from a large subcutaneous hematoma that pressed on the perforator pedicle. Normal clotting function was restored during the surgery by administering a factor XIII preparation (Fibrogammin® P). The patient with excessive clotting as a result of APS and SLE suffered necrosis of the flaps after undergoing radial forearm free flap (RFFF) and pedicled pectoralis major musculocutaneous (PMMC) flap operations. With clotting factor deficiencies, there are patients in whom no evidence of a coagulation disorder exists preoperatively. It is important for surgeons to pay close attention to the potential for coagulation disorders patients and to consult with specialists promptly when indicated. Level of Evidence: Level V, risk/prognostic study. © 2014 Springer-Verlag.

DOI： 10.1007/s00238-014-0933-9

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Venous malformations (VM) of lower extremities have characteristic symptoms, especially swelling, pain at rest or with dependence, or in the morning, or with exertion. Sclerotherapy has been applied and has been showed to alleviate the associated signs and symptoms. The aim of this study is to evaluate the outcomes of ethanol sclerotherapy for VM of lower extremities. Methods: The 21 patients of intramuscular VM of the lower extremities, who received percutaneous sclerotherapy using absolute ethanol in our institute, were reviewed retrospectively. The average age at the time of the initial diagnosis was 18.6 years, and average follow-up period after last sclerotherapy is 19.4 ± 13.5 months. The postinterventional changes of the associated signs and symptoms were evaluated by utilizing original VM scoring system. Results: The average number of sclerotherapy sessions was 2.6 times per case. The average total amount of ethanol used in each patient was 41.3 ml. Sclerotherapy reduced the associated signs and symptoms in many of the patients (n = 19/21). Preinterventional VM score as the overall baseline status was 10, and the average VM score after sclerotherapy was 4.1. There was no inverse correlation between the amount of ethanol used and the VM score. In seven cases treated more than three times, reverse correlation between the "VM score" and the number of sclerotherapy sessions was demonstrated (p &lt
0.05, ρ = 0.8214). Conclusions: The characteristic symptoms and signs of the VM were improved by sclerotherapy. More than three sessions of ethanol sclerotherapy improved the overall status of extensive intramuscular VM in lower extremities. Level of Evidence: Level IV, therapeutic study. © 2012 Springer-Verlag.

DOI： 10.1007/s00238-012-0754-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

We report 2 cases of presacral squamous cell carcinoma. In these cases, it was suspicious that the tumor disseminated to the internal iliac nodes through the direct pathway called the neurovascular lymphatic space (NVLS) around the superior/inferior gluteal vessels or sciatic nerve bypassing external iliac nodes. NVLS was initially reported as accessory pathway which follows the major vessels forming a sheath like structure with an actual or potential space between the vessel wall and the enveloping membrane. NVLS has been reported to be observed as a tubular shadow within the neurovascular sheath by lymphangiographies of lymphedema patients using oil-based contrast material. These cases provide insights into the potential pathway through which a cutaneous tumor disseminates.

DOI： 10.1097/SAP.0b013e31821daaac

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記述言語：日本語   出版者・発行元：The Japanese Skin Cancer Society  

DOI： 10.5227/skincancer.27.271

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その他リンク： http://search.jamas.or.jp/link/ui/2013207366

記述言語：日本語   出版者・発行元：The Japanese Skin Cancer Society  

DOI： 10.5227/skincancer.27.294

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その他リンク： http://search.jamas.or.jp/link/ui/2013207382

記述言語：日本語   出版者・発行元：The Japanese Skin Cancer Society  

DOI： 10.5227/skincancer.27.268

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その他リンク： http://search.jamas.or.jp/link/ui/2013207364

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nature Publishing Group  

In-transit metastasis (ITM) is a unique manifestation of intralymphatic tumor dissemination, characterized by the presence of melanoma cells between the primary lesion and the draining regional lymph node basin that is clinically associated with poor prognosis. In this study, we aimed to establish an experimental animal model of melanoma ITM, as research progress in this field has been hampered by a lack of suitable experimental models. We reproduced melanoma ITM in a mouse hind limb by transplanting melanoma cells into the footpad of a mouse with lymphedema (LE). The tumor cells at the ITM site were highly proliferative, and mice with ITMs were more likely than control mice to develop distant lymph node and lung metastases. Peritumoral lymphatic vessels and tumor-associated blood vessels were increased in the primary tumor site of the LE mice. Our established ITM melanoma mouse model enabled us to clarify the molecular determinants and pathophysiology of ITM. This ITM model is also comparable to the unfavorable clinical behavior of melanoma ITM in humans and, moreover, underlined the importance of lymphangiogenic factors in the tumor dissemination through the lymphatic system. © 2013 The Society for Investigative Dermatology.

DOI： 10.1038/jid.2012.274

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記述言語：日本語   出版者・発行元：The Japanese Skin Cancer Society  

DOI： 10.5227/skincancer.27.274

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その他リンク： http://search.jamas.or.jp/link/ui/2013207368

記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Lymphedema is known to be caused by many pathologic conditions; however, its correct diagnosis and optimal therapeutic strategies remain to be established. In this report, we describe an experimental model for acquired lymphedema in the lower extremity of the mouse that creates a lymphatic block in the groin induced by both radiation treatment and surgical division of the superficial and deep lymphatics. To evaluate the lymphatic system in this model, an indocyanine green fluorescence-sensitive camera system was used. This model has the advantages of relative technical simplicity and cost-effective use of a rodent animal model. Furthermore, a greater range of research tools such as antibodies and various databases are available for mice. This mouse model may be useful to anyone modeling lymphedema mechanisms, by providing a defined molecular context.

DOI： 10.1097/SAP.0b013e31821ee3dd

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記述言語：日本語   出版者・発行元：日本顔面神経学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Background There is no consensus on the most appropriate treatment for patients with large to giant congenital melanocytic naevi (CMN) because of the risk of melanoma development. Surgical excision followed by skin grafting or expanded skin coverage may cause unfavourable scarring. There is a balance to be achieved between minimizing the disfiguring appearance and the risk of malignant change. The pulsed dye laser (PDL) is commonly used for vascular lesions and is highly absorbed by melanin and haemoglobin. Its pulse duration is longer than that of Q-switched ruby lasers (QsRL), which can have nonspecific photothermolytic effects on surrounding nonpigmented naevus cells.
Objectives To investigate the effectiveness of combined treatment with the PDL and QsRL for large to giant CMN.
Methods Six patients with large to giant CMN were enrolled in this study. Treatment consisted of one pass of PDL treatment followed by one pass of QsRL treatment. Multiple rounds of treatment were applied to all patients.
Results All patients responded to this combined regimen, and the lesional colour was effectively reduced. The mean number of rounds of laser treatment required to achieve skin lightening was 7.7. No patients suffered severe hypertrophic scarring. No cases of recurrence or malignant transformation were observed. The histological results from the patient who underwent the most laser therapy in this study showed a remarkable reduction in the number of melanocytic naevus cells after treatment.
Conclusions This technique may enable the removal of most of the pigmented lesion and melanocytic naevus cells with minimal scarring.

DOI： 10.1111/j.1365-2133.2012.11058.x

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記述言語：日本語   出版者・発行元：道南医学会  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Background: Microsurgical transfer of the vascularised fat flaps has become a well-established method for soft-tissue augmentation because it has been believed to provide the restoration of symmetry without atrophy. Yet little has been reported on the long-term fate of the vascularised fat flaps. The purpose of this study was to evaluate the post-operative changes that occur in the vascularised fat flaps after transplantation.
Methods: The superficial epigastric fat flaps based on the superficial inferior epigastric vessels in rats were used for this study. Postoperative changes were analysed by comparing pre- and postoperative weight, histological examination and fluorescent angiography.
Results: The weight of vascularised fat flaps was 56 +/- 18% of the original weight (corrected for body weight gain) 24 weeks after transplantation. In histological examinations, the vascularised fat flaps had almost normal appearances throughout the experimental period. Apoptosis of adipocytes was detected in the vascularised fat flaps using terminal deoxynucleotidyl transferase (TdT)-mediated deoxy-uridine triphosphate (dUTP)-biotin nick end-labelling (TUNEL) method during the first 4 weeks after transplantation.
Conclusions: The vascularised fat flaps reduced in weight by about 44% over a period of 24 weeks after transplantation. Apoptosis may partly explain the weight loss.

DOI： 10.1016/j.bjps.2012.04.036

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

The purpose of this study was to evaluate the superficial lymph drainage patterns from primary lesions, with the primary focus on cheek/eyelid and lip melanomas.
We conducted a retrospective study of 22 patients with facial melanomas who had undergone neck dissection or sentinel lymph node biopsy at the hospital from 1981 to April 2011. We then analyzed the dominant lymph drainage patterns from the cheek/eyelid and lip regions.
The cheek/eyelid regions have two lymph drainage patterns: one is to the parotid nodes and the other is to level IB. The lymph drainage patterns in the lip region are to level IA or IB. The lymph drainage patterns to superficial lymph nodes from the primary sites were determined in both regions.
Cheek/eyelid and lip melanomas have lymph drainage patterns different from those of malignant tumors of the oropharyngeal and larynx regions. Superficial lymph node groups also play an important role in facial melanomas.

DOI： 10.1007/s10147-011-0293-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Background: The use of an interpositional nerve graft (IPNG) between the facial and hypoglossal nerves for incomplete facial palsy has recently been reported. However, its mechanism has not been elucidated. We established a rat model of IPNG to study incomplete facial palsy and confirmed the direction of innervation through the grafted nerve with or without facial nerve injury.
Methods: Twenty rats were divided into five groups (n = 4): a control group (group A), an incomplete facial palsy group (group B), an IPNG-treated group (group C), an incomplete facial palsy group treated with IPNG (group D) and an incomplete hypoglossal nerve palsy group treated with IPNG (group E). After surgery, mimetic muscle movement was evaluated using an original scoring system. Twelve weeks after surgery, the mimetic muscles of the tongue were injected with Fast Blue and DiI. Retrograde-labelled neurons were counted through the facial and hypoglossal nuclei, and mimetic muscle specimens stained with Masson's trichrome were examined.
Results: Fast Blue-labelled neurons were noted in the hypoglossal nucleus in groups C and D, and DiI-labelled neurons within the facial nucleus were noted in groups C and E. The group D facial palsy score statistically exceeded the group B score.
Conclusions: The results revealed that axonal regeneration through IPNG is bi-directional and is preferentially directed towards the injured side. Innervation from the hypoglossal nerve to mimetic muscles through IPNG prevents muscle atrophy and helps counter facial palsy. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjps.2011.12.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Background Published reports indicate that corticosteroid injections can prevent recurrence after keloid excision, but the side effects of repetitive intralesional steroid injections may preclude treatment maintenance. Additionally, few of these studies employed a standardized treatment protocol. Objectives To analyze the results of a new uniform treatment protocol combining corticosteroid injections and ointment application designed to reduce recurrence rates after excisional surgery in individuals with keloids or hypertrophic scars. Methods As a standard procedure, the first corticosteroid injection took place after removal of the sutures and then once every 2 weeks after that until it had been done five times. In addition, all postsurgical wounds received self-administered steroid ointment application twice daily for 6 months after suture removal. Results Postoperative follow-up in this series ranged from 24 to 57 months (median 32 months, mean 32.5 months). Recurrence occurred in three of the 21 keloid cases (14.3%) and one of the six hypertrophic scar cases (16.7%). Conclusion We evaluated a new standardized adjuvant corticosteroid therapy to prevent recurrence after surgical keloid or hypertrophic scar excision. Using this method, we achieved low recurrence rates.

DOI： 10.1111/j.1524-4725.2012.02345.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Background The triple technique (lymphoscintigraphy, patent-blue staining, and a gamma probe) constitutes a reliable method for the sentinel lymph node (SLN) biopsy. However, in head and neck melanomas, a shine-through phenomenon, which occurs because these SLNs are close to the primary focus, is irreversibly problematic. To get around the shine-through phenomenon, this study uses the fluorescence navigation with indocyanine green (ICG) as well as the triple technique.
Methods. ICG is a green dye and can be used as a marker with infrared fluorescence. ICG solution is intradermally injected around the tumor. By using Photodynamic Eye ( PDE) intraoperatively, it is possible to observe the injected ICG as SLNs in the fluorescence images.
Results. By use of the fluorescence imaging with ICG, clear identification of the SLN of the case became possible.
Conclusions. We think the fluorescence navigation with ICG will be a useful option for the SLN biopsy in head and neck melanomas. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 758-761, 2012

DOI： 10.1002/hed.21651

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Background: Treatment in malignant periorbital tumours requires a radical resection of the tumour, and reconstruction of eyelid defects is difficult task because it should aim at gaining functional and aesthetical improvement.
Methods: We have reviewed 50 cases of malignant periorbital tumour that were treated surgically from 1992 to 2010. We assessed the type of reconstruction performed, and present or absent of any complication.
Results: The decision of the appropriate reconstructive procedure was based on the location of the tumour and the size of the defects. For the upper eyelid, switch flap from lower lid was performed in 11 out of 14 patients those defects exceeding 50% of the horizontal length. There were 21 complications (42%); major complications in 11 patients (22%) and minor complications in 10 patients (20%). Major complications have occurred only in upper eyelid or in lower eyelid. All of the major complications appeared in the patients with larger defects exceeding 50%.
Conclusions: The 72% of major complications were associated with reconstruction of larger defects in upper eyelid. It might be extremely difficult to obtain good results in the patients with large upper eyelid defects, although switch flap is applicable to such defects. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjps.2011.09.012

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記述言語：日本語  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In-transit metastases of melanoma almost certainly results from lymphatic dissemination of melanoma cells to tissues between the primary melanoma site and the draining regional lymph nodes. Most in-transit metastases occur after lymphatic obstruction, due either to tumor involvement or to surgical removal. The treatment of in-transit metastatic melanoma has not been standardized, and should be tailored accordingly. We report a case of in-transit metastatic melanoma in head and neck after regional lymph node dissection. In-transit metastases in the cheek were excised with tailored surgical margins based on the evaluation of lymph flow using indocyanine green (ICG) fluorescence lymphography. ICG fluorescence lymphography has been reported recently in non-invasive sentinel lymph node mapping, and lymphaticovenous anastomosis. Using this system, not only sentinel lymph nodes and lymph vessels but also dermal lymphatic back flow caused by previous surgery is detectable as a white spot through fluorescence high-sensitivity near-infrared video camera system. This enables our detection of abnormal lymphatic flow, which indicates possible areas of melanoma cell spreading through the lymphatic system. Although a preliminary case report, we propose tailored excision of in-transit metastatic melanoma based on ICG fluorescence lymphography. © 2010 Springer-Verlag.

DOI： 10.1007/s00238-010-0526-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Radiation therapy for breast cancer has improved survival rates; however, a consequence of this is treatment-induced complications in longer-living patients. Decades after chest wall irradiation, very late onset radiation-induced osteomyelitis can develop, caused by osteoradionecrosis. This may lead to the development of small, but very refractory, skin ulcers. Many reports recommend well-vascularized tissue coverage after appropriate debridement for irradiation ulcers; however, when the ulcers are of very late onset, this sometimes causes recurrence of ulceration in non-muscle-covered areas after flap transfer. Thus, for very late onset cases, we propose treatment with an absolute muscle flap to cover both the obviously infected focus and the surrounding irradiated area. A muscle flap consisting of the entire latissimus dorsi, the shape of which is very large in the horizontal direction, satisfies this requirement. Latissimus dorsi muscle coverage for the treatment of very late onset osteomyelitis should be reappraised.

DOI： 10.1007/s00595-011-0078-4

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出版者・発行元：日本皮膚悪性腫瘍学会  

72歳，男性。30歳頃から両下腿静脈うっ滞性潰瘍に対し，他院循環器外科にて加療されていた。1年前頃より左下腿潰瘍部が隆起し，剥削術を施行したが再度隆起してきたため，前医形成外科を受診。生検にて悪性腫瘍を疑い当科紹介。初診日の夜に自宅で動脈性出血による出血性ショックとなり救急車で近医に搬送。全身状態改善後，当科へ転院搬送となった。入院時，左下腿2/3周を占拠する25×15 cmの腫瘤，同側鼠径リンパ節の腫脹を認めた。入院後も腫瘍より動脈性出血を認めた。腫瘍の切除と出血の制御目的で大腿切断を行った。有棘細胞癌の病理診断であった。Foot careに携わる診療科の中で，皮膚悪性腫瘍の診断・治療も行うことのできる形成外科・皮膚科は，慢性創傷が悪性腫瘍の発生母地となる点や生検の重要性を啓蒙していく立場にあると考えられる。

DOI： 10.5227/skincancer.27.64

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：英語   出版者・発行元：WILEY-BLACKWELL  

DOI： 10.1002/micr.20916

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記述言語：英語   出版者・発行元：WILEY-BLACKWELL  

DOI： 10.1002/micr.20920

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Ethanol is a commonly used sclerosant for lymphatic malformation (LM), and recent evidence has shown that macrocystic LMs respond very well to percutaneous sclerotherapy. However, the volume of absolute ethanol that can be injected safely is small (0.5-1ml/kg), and that is the reason it is often ineffective in extensive LM. We report two cases of giant LM with occasional high fever and pain or abnormal gait. To overcome dose limitation and to prevent systematic toxicities, we performed both injection of absolute ethanol and aspiration of it after 5 min exposure to LM. The injected maximum ethanol dose per one session is 70-260 ml and no systemic complication occurred. The 1-3 sessions of those procedures reduced the frequency of high fever and improved the swelling of those lesions. The injection and aspiration technique maximises the efficacy of sclerotherapy for extensive macrocystic LM in adults. (C) 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.bjps.2010.09.003

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Background: Microsurgical lymphaticovenous implantation in lymphedema is done to create a lymphaticovenous shunt by an implantation of collecting lymphatics into the small vein, as reported previously. The authors have recently introduced ultrasonograpy and indocyanine green fluorescence lymphography into this procedure.
Methods: Nine cases of postmastectomy lymphedema had received preoperative venous marking using ultrasonography and lymphatic mapping using indocyanine green fluorescence lymphography. The concept of modification is to pick up the most effective point for microsurgical lymphaticovenous implantation that involves both subcutaneous veins and the dermal backflow of excess lymphatics. Objective improvement was analyzed by the percent reduction of edema circumference at two points of the affected forearm.
Results: Preoperative lymphography showed a spotty image for dermal backflow in all nine extremities, a linear image on the dorsal hand in six extremities, and a linear image on the forearm in three extremities. With an average follow-up of 17 months, three patients had excellent results with the reduction of edema circumference more than 50 percent for both the distal and proximal sites of the treated forearm. Four patients had good results with the reduction of edema circumference more than 50 percent at the distal or proximal sites, two patients had fair results, and no patients had poor results. The average number of modified microsurgical lymphaticovenous implantations was 3.7 per case.
Conclusion: Modified microsurgical lymphaticovenous implantation is expected to provide favorable results with aminimum number of these modified implantations, even though no linear lymph channel was detected by preoperative indocyanine green fluorescence lymphography. (Plast. Reconstr. Surg. 127: 1804, 2011.)

DOI： 10.1097/PRS.0b013e31820cf2e2

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

From the introduction of the Tanzer method in 1959, numerous modifications on microtia reconstruction with costal cartilage framework grafting have been described concerning the decrease of operation frequency and complications, reduction of sacrifice of donor sites and improvement of definition of constructed ears. In total reconstruction for microtia, the patient's main wish is to obtain an ear with a good shape and well-defined contour, which is an indispensable objective prior to other advancements. In this paper, the three main points required to obtain a constructed ear that looks like a real ear are pointed out. 1. Establishment of correct ear location : We use models of real ears varied in size and color to determine a suitable location for the new ear. 2. 2-dimensional proportion : To design a new ear with suitable proportions, we established standard lines for the design of the framework. 3. 3-dimensional definition : Two cliff lines, which are the inner surface of the helix and the inner surface of the concha, should be set clearly. Moreover it should be well expressed that the helix crus goes down under the antihelix on the one side and the superior and inferior crura go down under the helix on the other. The helix and the antihelix form an exact double helix. We designed a useful device that makes it possible to simulate the insertion of the framework and to check the results of a reconstructed ear intraoperatively. As a result, there is marked improvement in the precision of the framework construction as well as shortening in the operation time. We also use the device for the purpose of education or training in framework construction.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：1  

DOI： 10.1097/PRS.0b013e3181f95b4c

Web of Science

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL PUBLISHING, INC  

The authors have indicated no significant interest with commercial supporters.

DOI： 10.1111/j.1524-4725.2010.01774.x

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PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

The sentinel lymph node (SLN) is the first node in the lymphatic basin to be affected by metastatic tumor cells from a primary lesion. It provides a way to avoid elective neck dissection in a case in which there is no metastasis to the SLN. However, identification and excision of the SLN may be difficult due to the shine-through phenomenon, as the SLN in the parotid gland is either located close to the primary lesion or, in many cases, the lymph node of the parotid gland is small and covered by fibrous capsula. When we conducted an SLN biopsy on a 68-year-old male patient with malignant melanoma of the cheeks, the metastasis to the node of the parotid gland identified as the SLN was negative; however, 1 year later, the melanoma recurred on the lymph node of the parotid gland, or in other words, we experienced a false-negative SLN. SLN biopsy in the parotid gland is difficult because the lymph node is small and covered by fibrous capsula. We may consider a total or partial resection of the superficial lobe of the parotid gland, particularly when identification of an SLN in the parotid gland is difficult. Therefore, we propose a new algorithm for SLN biopsy in the parotid gland.

DOI： 10.1007/s10147-010-0063-8

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PubMed

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本熱傷学会  

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語  

DOI： 10.5981/jjhnc.35.217

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記述言語：日本語   出版者・発行元：日本皮膚悪性腫瘍学会  

手術可能な進行皮膚悪性腫瘍の遠隔成績は必ずしも良くなく，補助的治療法が模索されているが，根治術後化学療法の意義は未だ明らかになっていない。今回我々は，皮膚悪性腫瘍（有棘細胞癌，皮膚附属器癌，乳房外Paget病）の局所進行例，リンパ節転移症例5例を対象に，5－FU系経口抗悪性腫瘍薬S－1を用いた術後補助化学療法のpilot feasibility studyを行った。S－1 80mg/m2/日，2週投与2週休薬で1年間内服を目標とした。副作用は軽度で，再発のため中止した症例を除き5例中4例で完遂できた。S－1は服薬コンプライアンスも良好で，安全に施行できる方法と考えられた。本法の有効性はいまだ不明であり，症例集積，比較臨床試験が必要と考えられるが，皮膚悪性腫瘍に対する根治術後補助化学療法として検討される価値があるかもしれない。

DOI： 10.5227/skincancer.24.301

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Hemifacial microsomia (HFM) and Treacher-Collins syndrome (TCS) are forms of mandibulofacial disostoses that have various severities of hypoplasia of mandibular condyle and lack of soft tissue. Mandibular distraction osteogenesis (DO) has become one of the most suitable operative procedures for micrognathia. We reviewed thirteen cases of HFM and five cases of TCS that underwent mandibular DO to verify its effectiveness and problems. In HFM, ce-phalometric analysis showed relapse of occulusal cant in all three cases that underwent mandibular DO without simultaneous maxillary distraction. The control of maxillary development may be important for successful mandibular DO for severe HFM. In TCS, a three-dimensional distracter was required for the treatment of severe open bite, and distraction ge-nioplasty with hyoid advancement was applied to two cases with severe obstructive sleep apnea. TCS patients require multiple surgical operations, therefore, it is necessary to construct a detailed plan for long-term treatment. DO can expand soft tissue as well as bone and is a useful option especially for the preparation of additional treatments such as Two-Jaw surgery.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The pathophysiology of involutional entropion is multifactorial and correction of the multiple causes may require use of a combination of procedures. Here, we report the outcome of treatment of entropion of the lower eyelid using the rhytidoplasty and modified Celsus-Hotz procedure for 29 Japanese patients. The patients comprised nine males and 20 females of age 44 to 86 years old (average age 69 years old). A postoperative assessment was performed in our office or by telephone interview. There were no cases of secondary ectropion and almost all of the patients were pleased with the results. This combined procedure is a simple approach with reduced invasiveness that can address almost all the main factors that contribute to formation of involutional entropion in Asian patients. In our patients, postoperative complications were rare and the results were satisfactory in terms of functional and aesthetic improvement. © 2009 Springer-Verlag.

DOI： 10.1007/s00238-009-0336-5

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING  

BACKGROUND Sclerosants are used to treat vascular malformations. Owing to variations in the flow, the injected concentrations and the duration of exposure of these sclerosants are altered. Therefore, the clinical effectiveness of sclerotherapy is variable.
OBJECTIVE The objective was to evaluate the differences in clinical response, usually observed among ethanol, polidocanol, and OK-432, using an in vitro sclerotherapy model.
METHODS Endothelial cells were cultured and exposed to different concentrations of the sclerosants for 5 seconds and the remaining viable cells were counted using a MTT assay kit. Dyes were used to visualize the morphologic changes. Precipitant formation in blood was also evaluated. Finally, the degree of ICAM-1 expression, after exposure to lower concentrations of these sclerosants, was studied using immunocytochemistry.
RESULTS Only ethanol causes precipitant formation and kills almost all cells from 30% concentration. Polidocanol begins to disrupt the cell membrane from 0.0125% onward. Only OK-432 induces ICAM-1 expression.
CONCLUSION Ethanol's strong precipitant-forming effect may induce thromboembolism, thus enhancing sclerosis. Polidocanol's endothelial cell-lysing effect was clearly documented. OK-432 may mediate its effect by inducing inflammatory response of the endothelium via ICAM-1 expression. This in vitro model may be useful in evaluating other sclerosants as well.

DOI： 10.1111/j.1524-4725.2007.33315.x

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記述言語：日本語   出版者・発行元：(一社)日本マイクロサージャリー学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Treacher Collins syndrome (TCS) is a congenital, craniofacial disorder affecting the development of structures derived from the first and second branchial arches. The associated clinical features and their severity are variable. Therefore, we reasoned that objective assessment of the clinical features and their severity in TCS is necessary to plan the treatment and to evaluate the outcome. We hereby propose a new grading system for Treacher Collins syndrome (TCS). Since 1978, 16 patients have been diagnosed with TCS. Eleven out of the 16 TCS patients, for whom we were able to estimate the severity of the clinical features in each region, and to make an objective assessment of the therapeutic outcomes, were selected. By allocating points according to the degree of severity of the clinical features in each region, then summing them up and categorizing them, we classified the overall clinical features into 3 grades. The severity increases from grades I to III. In summary, there were 3 patients of grade 1, 4 patients of grade 11 and 4 patients of grade III. Distinctive differences regarding the degree of severity of the clinical features were clearly observed between each grade. We propose a new TCS grading system and applied it to 11 patients. We believe that this system may be useful for planning treatment and to evaluate the outcome in TCS patients.

DOI： 10.1097/SCS.0b013e31802cf3ff

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記述言語：日本語  

DOI： 10.5981/jjhnc.32.241

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.12968/jowc.2006.15.2.26893

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PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

The ischial region is a common site of pressure sore. The ischial pressure sore with a large subcutaneous bursa is resistant to conservative treatment and tends to require radical surgical treatment. In this article the authors describe their experience with a simple surgical treatment on 8 ischial pressure sores in 7 patients with subcutaneous bursa by means of sclerotherapy using absolute ethanol. This method involves causing the bursa to become scarred and closing it up by sterilizing, fixing, and denaturing by the pharmacologic effect of absolute ethanol instead of surgical excision of the bursa. This alternative method has a possibility of treating pressure sores as well as other fistulous diseases in various areas.

DOI： 10.1097/01.sap.0000134648.16439.0c

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PubMed

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記述言語：日本語   出版者・発行元：The Japanese Skin Cancer Society  

Angiosarcoma of the scalp is a relatively rare malignant endothelial tumor. We experienced a case of angiosarcoma treated by wide local excision. An 85-year-old man was admitted to our hospital with a tumor which had appeared 1 month before on his left temporal region. The diagnosis of angiosarcoma was made based on the clinical features and histopathological finding of the lesions on the skin by a former institution. We performed wide local excision immediately circumferentially to a distance of more than 3-5cm from the tumor margin. At present, 13 months after surgery, no recurrence or metastasis has been observed. [<i>Skin Cancer (Japan)</i> 2003; 18: 51-55]

DOI： 10.5227/skincancer.18.51

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2003264892

担当区分：筆頭著者   記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）   出版者・発行元：全日本病院出版会  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   掲載種別：記事・総説・解説・論説等（その他）   出版者・発行元：市立函館病院  

過去3年間に当院で経験した犬咬傷11例(男性3例、女性8例、平均年齢43.3歳)、猫咬傷16例(男性5例、女性11例、平均年齢56.6歳)について検討した。その結果、受傷部位は犬、猫とも手指が最も多かった。受診日は犬咬傷では受傷当日が8例、受傷翌日が3例、猫咬傷では受傷当日が4例、受傷翌日が7例、それ以降が5例であった。感染は犬咬傷で6例(54.5%)、猫咬傷で11例(68.8%)に認めた。創部の細菌培養検査は猫咬傷の3例で行い、いずれもPasteurella multocidaが検出された。治療内容では破傷風トキソイドのみ投与したものが犬咬傷7例、猫咬傷6例であった。破傷風トキソイドと抗破傷風免疫グロブリンを投与したものは犬咬傷、猫咬傷とも各1例ずつであった。一方、いずれの投与も行わなかったのは犬咬傷3例、猫咬傷9例であった。尚、全例で破傷風の発症はみられず、治療期間は犬咬傷で平均15.3日、猫咬傷で平均10.9日であった。

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01247&link_issn=&doc_id=20181120400013&doc_link_id=http%3A%2F%2Fid.nii.ac.jp%2F1599%2F00016334%2F&url=http%3A%2F%2Fid.nii.ac.jp%2F1599%2F00016334%2F&type=%8ED%96y%88%E3%89%C8%91%E5%8Aw%81F%8ED%96y%88%E3%89%C8%91%E5%8Aw%8Aw%8Fp%8B%40%8A%D6%83%8A%83%7C%83W%83g%83%8A_ikor&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80183_3.gif

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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記述言語：日本語  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

口腔癌の血管柄付遊離皮弁再建術後に生じた中心静脈カテーテル関連深部静脈血栓症を2例経験したので報告するとともに、北海道大学病院では2014年7月から「歯科医師のための血栓発見時の対応マニュアル」の運用を行っているので紹介する。症例1:60歳男性。右口底癌cT4aN1M0の診断で、2010年5月に右頸部郭清術、口底悪性腫瘍切除術、前外側大腿皮弁による再建術を施行した。麻酔の導入時に大腿静脈より中心静脈カテーテルが挿入され、術後5日目で抜去した。術前の4月の上部消化管内視鏡検査で早期胃癌が発見されたため、内視鏡的粘膜剥離術を予定し、8月に腹部造影CTを撮像したところ、下大静脈内に7cm長の血栓が認められた。深部静脈血栓症の診断のもと循環器内科の指示でワルファリンカリウムの内服を開始した。2週後の腹部造影CTで下大静脈血栓の縮小を認め、2ヵ月後に血栓の消失が確認された。症例2:69歳女性。左舌癌cT2N0M0の診断で、2014年2月に左頸部郭清術、舌亜全摘術、前外側大腿皮弁による再建術を施行した。麻酔の導入時に大腿静脈より中心静脈カテーテルが挿入され、術後7日目で抜去した。術後1週間でプロスタグランジンE1製剤が原因と考えられる薬剤性肝機能障害を認めたため、腹部超音波検査、腹部造影CTを施行した。その際に、右大腿静脈、右総腸骨静脈〜下大静脈にかけて血栓形成が発見され、深部静脈血栓症の診断のもとヘパリンナトリウムを開始した。1週間後の腹部造影CTにて血栓の消失が確認された。(著者抄録)

DOI： 10.5843/jsot.29.1

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記述言語：日本語   出版者・発行元：(株)全日本病院出版会  

(1)ケロイド治療は患者個々に適した治療を随時選択するオーダーメイド治療である。(2)ケロイド患者が完遂できる治療法を提供することが必須である。(3)そのためには治療法の選択肢が多いこと、また個々の治療法に一定のプロトコルが存在することが重要である。(4)限られた既存の治療法の選択肢から複数の治療法を併用するなどの工夫も必要である。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)全日本病院出版会  

ケロイドを手術単独で治療した場合、再発率は極めて高くなる。ケロイドの再発を制御し得る術後補助療法の確立があって初めてケロイドの外科的治療が可能となる。ケロイドの外科的治療にあたっては、術後の再発のリスクが軽減することを意識した切除と再建を行う。術後補助療法として我々の施設では放射線照射の他に、ステロイド局所注射と外用を併用するステロイド強化療法を行っている。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)全日本病院出版会  

ケロイド・肥厚性瘢痕切除後の電子線照射とステロイド局注療法について検討した。ケロイド、肥厚性瘢痕に対して手術療法を行った後にステロイド強化療法を行った40例(男性8名、女性32名、平均44.5歳)および電子線照射を行った5例(男性3名、女性2名、平均39.4歳)を対象にアンケートを実施し、24例から回答を得た。「電子線照射とステロイド強化療法の説明をきいて、ステロイド強化療法を選択された理由についてお答え下さい。」に関して45件の回答があった。最も多かった回答は「手術からその後の治療まで同じ主治医(形成外科)が行う方が安心」という項目で67%、次に「通院の頻度が自分に合っている」という項目で46%であった。「実際にステロイド強化療法を行ってみて、その結果についてどのようにお考えでしょうか」に関して24件の回答があり、「満足」が54%、「やや満足」と合わせると75%となった。電子線照射を選択した症例の治療選択理由は、植皮、皮弁を行った広範囲が3例、遠方で定期的な通院が不可能なため入院治療を行った例が1例、ステロイド注射の疼痛を理由に電子線照射を選択したが1例であった。

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記述言語：日本語   出版者・発行元：(一社)日本熱傷学会  

2009年1月より保険収載された自家培養表皮(ジェイス)は、自家植皮のための恵皮面積が確保できない重篤な広範囲熱傷において有効な治療の選択肢となっている。広範囲熱傷患者において自家培養表皮を使用するには、皮膚組織を採取してから培養、シート作成までに約3週間を要する点、感染対策や移植床の再構築を必須とする点など、乗り越えるべき問題も多い。計画どおりに移植まで到達する過程が重要であり、自家培養表皮の使用効果が十分に発揮できる症例を見極める必要がある。そこで、自家培養表皮の使用が効果的となりうる急性期熱傷症例の選択について、当院の過去5年間の治療結果をもとに検討した。2010年1月から2014年12月までの5年間に当院へ救急搬送後、形成外科で手術治療を行った急性期熱傷症例のうち、自家培養表皮使用の保険適応を満たす症例を対象とした。患者の年齢、性別、受傷部位、受傷面積、熱傷指数(以下BI)、熱傷予後指数(PBI)、転帰について検討した。さらに自家培養表皮移植を行った症例では、移植部位、移植床、移植方法、表皮形成率、BI層別(BI40〜50未満、BI60〜80未満)の生存率および表皮形成率について検討を加えた。自家培養表皮の保険適応症例は全9例(男性6例、女性3例)あり、年齢は19歳から72歳で、平均年齢は39.9歳であった。自家培養表皮を使用した症例は6例あった。自家培養表皮移植症例6例中4例がBI40から50未満で、生存率は100%、平均表皮形成率は62.5%であった。一方、6例中2例でBI60から80未満に使用し、2例とも死亡し、最終的な平均表皮形成率は0%であった。われわれの経験では、自家培養表皮の使用効果が得られやすい症例はBI40から50前後と考えられた。広範囲熱傷に対して自家培養表皮を適切に使用することで救命率の向上につながると思われる。(著者抄録)

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記述言語：日本語   出版者・発行元：(NPO)日本レーザー医学会  

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記述言語：日本語   出版者・発行元：市立函館病院  

舌小帯短縮症は，2?5％ほどの発生頻度を有する舌の先天異常で1），胎生期における舌原基と下顎歯槽粘膜の分離不全と，生後の舌小帯の短縮障害が加わって成立するとされている2）。その家系内発症はいくつかの報告があるに過ぎない。今回当院で舌小帯短縮症の家族例を経験したので，若干の考察を加えて報告する。

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その他リンク： http://search.jamas.or.jp/link/ui/2016105683

記述言語：日本語   出版者・発行元：全日本病院出版会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2015208416

記述言語：日本語  

J-GLOBAL

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記述言語：日本語  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：市立函館病院  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：全日本病院出版会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2014071448

記述言語：日本語   出版者・発行元：克誠堂出版  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2013255780

記述言語：日本語   出版者・発行元：全日本病院出版会  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2013222885

記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：The Japanese Skin Cancer Society  

DOI： 10.5227/skincancer.28.145

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記述言語：日本語  

CiNii Books

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記述言語：日本語  

CiNii Books

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(一社)日本皮膚悪性腫瘍学会  

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本頭蓋顎顔面外科学会  

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記述言語：日本語  

J-GLOBAL

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記述言語：日本語   掲載種別：書評論文，書評，文献紹介等  

The main pathogenesis of senile blepharoptosis has been postulated to be laxity of the skin or aponeurosis of the levator. We analyzed the widths of excised skin of 176 eyelids in 99 patients who underwent a skin resection procedure alone between April 2001 and June 2008 in our department. The widths of excised skin were most commonly 10 mm and the average width was 10.4 mm. Patients in their seventies were the most common and the average of age was 72 years old. There was no significant difference between the right and left sides, and between males and females. We observed a significant difference in the widths of excised skin between the patients in their fifties and sixties, but no significant difference was observed between any other consecutive generations. Unlike the impression monitored in the seated position with relaxing the frontalis muscles, the amounts of excess skin of the upper eyelids measured in the supine position showed no significant difference between each decade over the sixtie.

Scopus

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記述言語：日本語   出版者・発行元：医学書院  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2009288350

記述言語：日本語   出版者・発行元：(公社)日本皮膚科学会  

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記述言語：英語   出版者・発行元：NATURE PUBLISHING GROUP  

We investigated the metabolism of arachidonic acid in normal skin-derived fibroblasts (NF) as well as in keloid-derived fibroblasts (KF) in response to macrophage migration inhibitory factor (MIF), a pluripotent cytokine. We found that MIF enhanced cyclooxygenase-2 activity in NF more than in KF. Consistent with this finding, prostaglandin E-2 (PGE(2)), an antifibrogenic molecule, was more significantly increased in NF than in KF by MIF treatment. As regarding E prostanoid receptor 2, the level of expression was significantly lower in KF than in NF. On the other hand, Forskolin, a direct activator of adenylcyclase, decreased collagen synthesis in both NF and KF, which indicates that cAMP plays an important role in regulating collagen synthesis. As PGE2 induces cAMP production, it is conceivable that increased collagen synthesis in KF might be owing to decreased PGE2 and cAMP production. These findings may aid in the development of a therapeutic strategy for the regulation of collagen synthesis in keloid fibroblasts.

DOI： 10.1038/sj.jid.5700227

Web of Science

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記述言語：日本語  

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記述言語：日本語   掲載種別：書評論文，書評，文献紹介等  

Distraction osteogenesis has been the accepted procedure in craniofacial surgery. Herein, we present our cases of midface hypoplasia associated with Crouzon syndrome who have been treated with midface distraction. In our experience, halo distraction, compared with internal device, provided a significantly better outcome in midface advancement. This is because the external distraction device allows multidirectional, unlimited distraction and multiplanar adjustability of distraction forces at any time during the distraction procedure. In an advancement of monobloc osteotomy, distraction is also effective and may reduce morbidity by decreasing the large dead space between the nasopharynx and supradural space of the frontal lobe.

Scopus

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記述言語：日本語  

CiNii Books

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開催年月日： 2022年11月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

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開催年月日： 2022年4月

記述言語：英語   会議種別：シンポジウム・ワークショップ パネル（公募）  

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開催年月日： 2021年12月

記述言語：英語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2021年12月

記述言語：日本語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2021年12月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

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開催年月日： 2021年9月

記述言語：日本語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2021年8月

記述言語：日本語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2021年4月

記述言語：日本語   会議種別：口頭発表（招待・特別）  

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開催年月日： 2021年1月

記述言語：日本語   会議種別：シンポジウム・ワークショップ パネル（指名）  

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