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Biomedical subjects

H Kamiishi

Publications and source records attributed to H Kamiishi.

At least 19 recordsLinked to original sources

A rare case of a facial-nerve neurofibroma in the parotid gland.

The incidence of solitary neurofibroma of the facial nerve originating in the parotid region is extremely low. We report a case of a solitary neurofibroma in a 30-year-old male, who initially presented with a parotid mass without facial paresis or paralysis. A chain of small nodules had been palpable in the right parotid region for the previous 2-3 years. MRI and CT scans revealed several small ovoid lesions extending from the frontal margin of the parotid gland to the retromandibular region. The lesions were surgically removed. The main trunk of the facial nerve was adherent to the dorsal side of the largest nodule; however, this mass was resected atraumatically. Histopathological examination indicated neurofibroma. The incidence, presentation, diagnosis and surgical treatment of intraparotid neurofibroma are discussed and compared with those of Schwannoma.

Adult↗

New strategy for the diagnosis of parotid gland lesions utilizing three-dimensional sialography.

Three-dimensional (3D) imaging for parotid gland lesions was performed using 3D sialography. This method provided a detailed surface structure of the parotid gland, and made it possible to overcome the disadvantages of X-ray sialography, planar CT, and MRI. Immediately after the conventional sialography via an oral route, CT scanning was performed with a slice-thickness of 3 mm using a helical CT scanner. CT data were analyzed on a workstation to reconstruct 3D images. 3D sialography was found to have the following advantages: (1) The structure of the acinar surface is visualized in detail; (2) The 3D structure of the entire parotid system from Stensen's duct to the gland is shown in one image; (3) The parotid gland can be assessed in the context of the bony architecture of facial bones; (4) The surface structure of the parotid gland can be understood very easily, like a scanning electron micrograph. We conclude that 3D sialography is a useful imaging technique for parotid gland lesions.

Adult↗

Oculocardiac reflex induced by zygomatic fracture; a case report.

Oculocardiac reflex has been recognized as the result of mechanical stimulation to the orbital tissue. The authors encountered a case of severe arrhythmia due to oculocardiac reflex in a patient with a zygomatic fracture. Previous health examinations suggested no abnormalities in the heart in his schooldays, and the initial diagnosis of his arrhythmia as complete A-V block due to injury (using ECG and cardiac ultrasonography). Because his arrhythmia did not improve spontaneously, he underwent cardiac pacing. After repair of the fracture, his arrhythmia completely disappeared. The pacemaker was removed on the first postoperative day. The pathogenesis of this rare case will be discussed.

Adult↗

[Tissue engineering].

The new field of tissue engineering, applies the principles of biology and engineering to the development of functional substitutes for the loss or failure of an organ or tissue. This article describes the previous challenges and present status of this interdisciplinary field.

Animals↗

Atrial septal defect in cyanotic CL/Fr mice.

OBJECTIVE: It is widely known that some newborn CL/Fr mice with cleft lip and palate (CLP) also have cyanotic symptoms, which have been thought to depend on an atrial septal defect (ASD). In a previous study, we found that cyanotic mice tended to have more severe types of CLP. We hypothesize that the mechanical airway obstruction due to a poorly developed palatal shelf and unmoved tongue in CLP(+) mice might be related to the occurrence of cyanosis. The purpose of this study was to examine the relationships between ASD and cyanosis in CLP(+) newborns. METHOD: The newborn hearts from CLP(-), noncyanotic CLP(+), cyanotic CLP(+), CL/Fr mice and ICR mice were examined histologically, and the incidence and size of ASD was determined on neonatal day (ND) 0. In CLP(-) newborns, similar procedures were performed from ND 1 to ND 4. Furthermore, in CLP(+) newborns, development of the palatal shelf was examined. RESULTS: While all the ICR mice had a well-developed atrial septum, and the incidence of ASD was 0%, about 80% of CL/Fr mice had ASD, irrespective of the presence or absence of CLP and cyanosis. On ND 0, the septum primum was significantly shorter in cyanotic CLP(+) mice than in CLP(-) mice. It also tended to be shorter in CLP(+) mice than in CLP(-) mice. Between the cyanotics and noncyanotics, there were no significant differences in the incidences of ASD and the rate of septal development. In CLP(-) mice, the septum primum developed well later and no ASD was observed on ND 4. Cyanotic newborns had significantly less developed palatal shelves than did noncyanotics. CONCLUSIONS: Cyanosis may not be related to ASD and the rate of septal development, but may be related to the occurrence of CLP in this strain. Furthermore, we confirmed that some relationship exists between the development of the palatal shelf and cyanosis. The present study supports our hypothesis concerning the cause of cyanosis in CL/Fr mice.

Airway Obstruction↗

Application of medical thermography to the diagnosis of Frey's syndrome.

BACKGROUND: In Frey's syndrome, the secretory parasympathetic fibers of the parotid gland are thought to communicate with the sympathetic nerve fibers of sweat glands and blood vessels of the skin following parotidectomy. Miscommunication results in subjective gustatory sweating and facial flushing, which appear early with postoperative mastication. In this study, we compared the efficacy of medical thermography to the Minor's starch-iodine test to determine the presence of gustatory sweating in Frey's syndrome. METHODS: Patients were considered to have Frey's syndrome if signs of gustatory sweating and localized skin flushing of the parotid region were present. In four patients who had undergone unilateral parotidectomy, gustatory sweating and facial flushing were present after gustatory stimulation, and the presence of Frey's syndrome was confirmed with Minor's starch test in all patients. Infrared thermography was then performed, and the same area measured. The contralateral side served as an internal control for each patient. RESULTS: Before gustatory stimulation, the isothermal pattern of the diseased side and the nonoperative side was similar. Stress thermography using a sialogogue (lemon, 3 mL) showed a cold spot at the operative site in all four patients with Frey's syndrome. The contralateral nonoperative side showed normal skin temperature distribution in all patients. Minor's test was positive in all patients. CONCLUSIONS: Thermography is a noninvasive, facile test that provides a qualitative visual analysis of the cutaneous capillary response in Frey's syndrome following parotid surgery.

Adenocarcinoma↗

Embryologic features of term fetuses and newborns in CL/Fr mice with special reference to cyanosis.

OBJECTIVE: The objective of this study was to clarify the embryologic features of CL/Fr mice in relation to cyanosis. METHOD: Orofacial examinations were conducted on 18-day-old term fetuses and newborns. Except for open eyelids in a few cases, all of the external abnormalities in this strain were cleft lip and/or palate (CLP). RESULTS: The CLP incidence in term fetuses was 28.4%. The body and placental weights were not different between CLP(+) and CLP(-) fetuses. Several types of CLP were found; the most frequent was bilateral complete CLP (60%) followed by left complete (16%). Bilateral complete CL, which is the most severe CL type, was associated with poorly developed secondary palate and wide cleft. In newborns, 39.4 % of CLP(+) mice showed cyanosis, where no CLP(-) mice had such signs. The body weight of cyanotic mice with CLP was significantly lighter than that of noncyanotic mice with CLP. Cyanotic mice had severe types of CLP and unelevated palatal shelves. CONCLUSION: We suggest that mechanical airway obstruction may be one of the causes of cyanosis in newborn CL/Fr mice.

Airway Obstruction↗

Enhanced urokinase-type plasminogen activator activity by extracellular matrix protein obtained from highly metastatic human lung adenocarcinoma cell line.

A protein which enhanced urokinase-type plasminogen activator (u-PA) activity was purified from the extracts of extracellular matrix of highly metastatic cell line HAL-8 derived from human lung adenocarcinoma. The protein showed a single band with molecular weight of 65 kDa after the purification by Sephadex G-150 and diethylaminoethyl-cellulose followed by reversed phase separation in a high performance liquid chromatography system. The purified protein in the immobilized conditions enhanced u-PA activity in both plasminogen activation and S-2444 amidolysis by 4.6- and 2.8-fold increases in the second order rate constants (Kcat/K(m)), respectively. This protein was related to neither plasminogen nor single-chain u-PA by the immunological studies and with respect to retention time on reversed phase analysis. These results suggest that the purified material acts as an enhancer of u-PA in extracellular matrix of the cancer cells, inducing an effective tissue destruction and cell invasion and possessing a highly metastatic potential.

Adenocarcinoma↗

Clinical outcome of digital replantation using the fibrin glue-assisted microvascular anastomosis technique.

A series of 36 digital replants is reported in which microvascular anastomoses were each performed with four to six stitches and topically applied fibrin glue. Thirty-two digits survived, comparable to survival with conventional microvascular anastomosis. The average operative time per replanted digit was 3.2 hours, considerably less than documented with standard replantation technique (4.5 hours per digit). These clinical findings indicate that fibrin glue-assisted microvascular anastomosis does not compromise replant outcome and can reduce the operative time by reducing the number of microsutures that need to be placed in each anastomosis.

Adolescent↗

Patterns of thermoregulation associated with cold intolerance after digital replantation.

Twelve patients with complete thumb amputations were analyzed to determine the interrelations between thermoregulation for pain and cold intolerance and sensory nerve recovery. Patients were examined at 3 months, 6 months, 1 year, and after 2 years following replantation. Medical thermography was introduced to assess postoperative circulation following digital replantation, while vasomotor tone was assessed by cold-stress plethysmography testing. Postoperative circulation was divided into two different patterns based upon skin temperature, the transition of which over time correlated well with sensory nerve recovery. Patients with cold intolerance showed a persistent vasoconstriction pattern, the cold change of which was objectively detected by thermography.

Adult↗

Effect of hypertension on arterial structure and wound repair at the microvascular anastomosis site using stroke-prone spontaneously hypertensive rats (SHRSP).

Different processes of microvascular wound healing under hypertension in comparison to normotension have been suspected. To explore these differences at the site of anastomotic wound repair, we performed microvascular anastomoses of the femoral arteries in 12-week-old, stroke-prone hypertensive rats (SHRSP) whose maximum blood pressure reached 238 mm Hg and in normotensive age-matched Wistar Kyoto (WKY) rats. Morphologic changes under hypertension were examined via light microscopy. The arrangement and number of endothelial cells were examined using the en face silver staining technique. The plasma activity levels of factor XIII were also measured in each group. Transitional healing at the microvascular anastomosis site was evaluated via scanning electron microscopy. The extent of endothelial migration over the exposed media around the needle holes was determined using a computerized graphic analysis system. Histologic cross sections demonstrated a thickened media, with altered shape and arrangement of the smooth muscle cell nuclei in SHRSP arteries compared with WKY arteries. En face silver staining showed small and spindle-shaped endothelial cells with an irregular cell arrangement and distribution in SHRSP arteries relative to WKY arteries. Factor XIII was increased 36% over baseline in SHRSP rats postoperatively; this was significantly higher than the increase in WKY rats (P < 0.05). Although both SHRSP and WKY arteries had similar wound healing responses to microvascular anastomosis, endothelial cell migration over the exposed media was significantly accelerated in the SHRSP rats.

Anastomosis, Surgical↗

Use of fibrin glue to minimize bleeding of microvascular repairs in hypertensive rats.

The purpose of this study is to describe our technique of applying fibrin glue at the microvascular anastomotic site and to evaluate the effect of fibrin glue on anastomotic hemostasis and patency under various high pressure states using dopamine-induced acute hypertension in rats. A total of 72 male Wistar Kyoto rats, 10 weeks old, were used in this study. Under urethane anesthesia, end-to-end anastomosis of the left femoral artery was performed using 10-0 nylon suture by the standard interrupted suture technique. Pasteurized fibrin glue was then topically applied upon the suture line of the anastomosis. Thirty-six normotensive rats were divided into three groups based on the number of sutures (4, 6, or 8) used to complete the anastomosis. Groups were subdivided, half receiving fibrin glue application and half without. Thirty-six dopamine-induced acutely hypertensive rats were divided into three groups based on the blood pressure levels of 150, 200, and 250 mmHg, respectively. These groups were again subdivided, with half receiving glue applications. Microvascular anastomosis was performed using 6 nylon sutures. Patency rates and anastomotic bleeding were evaluated. The results revealed that successful anastomoses could be performed with fewer sutures when fibrin glue was used as a reinforcement at the anastomosis. Fibrin glue was also effective at the maximum blood pressure (250 mmHg) with no anastomotic leakage and no decrease in postoperative patency rate. These results suggest that conventional microsurgical suturing technique combined with fibrin glue would be effective in the prevention of leakage in microsurgical repairs, even under conditions of high blood pressure.

Anastomosis, Surgical↗

The observation of endothelial cells in vein grafts by the en face silver staining method.

The introduction of en face silver staining to microsurgery has provided useful, detailed information about endothelial cells with regard to their size, shape, and number. With this staining method, endothelial cells of rat vein grafts have been morphologically investigated following division of the site of observation into three areas: the recipient artery, the proximal part of the vein graft, and the midportion of the vein graft. The results show that the arterial endothelial cells are small and spindle-shaped, whereas the cells in the proximal vein graft location are larger. Finally, large, rounded endothelial cells are seen in the midportion of the graft. These results are quantitated through a computerized graphic analysis system, which provides estimations of the cell size, Feret's diameters, and irregularities in the cell borders. The combination of en face silver staining and computerized graphic analysis has been especially useful for comparing minute changes that occur in recovering/regenerating endothelial cells.

Animals↗

Experience of surgical treatment for craniofrontonasal dysplasia.

We present a case of a 5-year-old girl diagnosed as having craniofrontonasal dysplasia (CFND), which was first reported by Cohen in 1979. CFND is very rare and reports concerning this syndrome have never been found in Japan. In our case, frontal plagiocephaly, third degree orbital hypertelorism and clefting nasal tip coexisted. At 10 months after birth when she visited our hospital, signs of craniostenosis were not recognized and cosmetic improvement was considered the main purpose of the treatment. We performed supraorbital bar reshaping, ethmoidectomy and orbitotomy for reconstruction in one-stage at the age of five. The operation produced marked improvement in her exotropia before entering a primary school. Past reports dealing with abnormalities of the central nervous system in this syndrome are few, but agenesis of the splenium was noted in our case. This paper is a report of our findings together with some discussions in reference to the literature.

Child, Preschool↗

Wound healing at the site of microvascular anastomosis: fibrin-stabilizing factor XIII administration and its effects.

Factor XIII has recently been recognized to play an important role as a fibrin-stabilizing factor to accelerate the wound healing process. We made an attempt to analyze the effect of how Factor XIII affects the results of the healing process at the site of a microvascular anastomosis. The strong fibrin stabilizing property of plasma Factor XIII maintained its high activity when administered intravenously and was effective for wound healing in a low-activity state made by subcutaneous administration of carbon tetrachloride. The enhanced network formation of the Factor-XIII-injected group was indicated by the accelerated maturation of the fibrin structure at the anastomotic site, exhibited both qualitatively and quantitatively. Stimulation and acceleration by Factor XIII of the healing process at the site of microvascular anastomosis were observed. It is therefore suggested that clinical use of Factor XIII may enhance the microvascular repair process. Details of the analysis using scanning electron microscopy (SEM) and a computerized graphic analyzer system (CGAS) are reported.

Anastomosis, Surgical↗