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Mitsuo Hatoko

Publications and source records attributed to Mitsuo Hatoko.

29 records · Page 2Linked to original sources
PubMed2003

Auricular composite graft for skin defect of the philtrum dimple.

Our method of performing an auricular composite graft for a skin defect of the philtrum dimple in a patient whose lip is not damaged and has retained its original softness and elasticity is presented. After resecting the lesion, an auricular composite graft is harvested from the conchal region. The size of the graft is almost the same as the size of the resected lesion, although the cartilage is harvested in an elliptical shape, and its size is approximately 60% in area of the overriding skin of the graft. The graft is harvested from the site, which has a similar curvature to the defect. The cartilage is sutured tightly to the graft bed at a minimum of four points with 6-0 absorbable suture. The transversal axis of the harvested cartilage is sutured as vertically as possible so as to fit the direction of the wrinkle line of the upper lip. The skin is sutured to the defect margin using 5-0 nylon suture. The graft donor site is closed primarily. This method has been used for the closure of six comparatively large skin defects after resecting a skin lesion (pigmented nevus in three cases and hypertrophic scar in three cases) in the philtrum dimple in six patients. In all cases, the upper lip was not damaged and retained its original softness and elasticity. The "take" of the graft was complete in all patients, and the donor site healed without any problem. In all cases, postoperative shrinkage of the graft was not significant during the follow-up period, and the graft had a smooth surface. In addition, no patients suffered from a feeling of discomfort in moving the mouth, and an acceptable shape of the philtrum dimple was achieved in all cases. There were no deformational changes in the graft donor site. In conclusion, our method is valid in the patient whose lip is not damaged and has retained its original softness and elasticity and in whom a full-thickness skin graft is selected as the covering method for a skin defect of the philtrum dimple.

Adolescent↗
PubMed2002

Rare case of a rudimentary medial metatarsal non-ossified structure.

A 9-year-old boy presented with a rudimentary medical metatarsal non-ossified structure. We considered his condition to be classified as hypoplastic medial member type in the metatarsal type of medial ray polydactyly. When it was considered as polydactyly, it had the longest delay of ossification among reported cases.

Child↗
PubMed2002

Difference of molecular response to ischemia-reperfusion of rat skeletal muscle as a function of ischemic time: study of the expression of p53, p21(WAF-1), Bax protein, and apoptosis.

The authors investigated the expression of p53, p21(WAF-1), Bax protein, and apoptosis to elucidate the cellular response to ischemia-reperfusion of skeletal muscle using the rat lower limb model. The rat left lower limb was dissected in the inguinal region, isolating the bony femoral muscles, and the femoral vessels were clamped to produce an ischemic condition. After 3 or 6 hours, the clamps were removed and the gastrocnemius muscle was resected at various times up to 72 hours after reperfusion. Five specimens of the muscle were obtained at each time point from 5 rats. When any rat died during the study, additional rats were used until 5 specimens could be obtained from 5 rats at each time point. The expression of three proteins was detected by Western blot analysis. The apoptotic cells were detected using terminal deoxytransferase-mediated dUDP (deoxyuridine[-5']diphosphate) nick-end labeling assay. Histopathological study showed severe interstitial edema and leukocyte infiltration at 6 hours of ischemia compared with 3 hours of ischemia. Moreover, at 6 hours of ischemia, muscle fiber fragmentation was observed at 72 hours after reperfusion whereas no fragmentation was found at 3 hours of ischemia. At 3 hours of ischemia, p53 and p21(WAF-1) accumulated after reperfusion, and there was a time lag in the time of onset of elevation and the peak time point between these two proteins. The level of Bax protein did not elevate and the rate of apoptotic cells did not increase. At 6 hours of ischemia, p53 and p21(WAF-1) also accumulated, but the kinetics of p21(WAF-1) were similar to that of p53 in the time of onset of elevation and the peak time point after reperfusion. In addition, the level of Bax protein increased and apoptosis was induced. These results demonstrated that p53 and p21(WAF-1) accumulated after 3 and 6 hours of ischemia of skeletal muscle during reperfusion. Moreover, it was demonstrated that the kinetics of induced p53, p21(WAF-1) and Bax protein differ between 3 hours and 6 hours of ischemia, and it is speculated that this difference plays an important role in determining the consequence of the cell exposed to ischemia.

Animals↗
PubMed2002

Evaluation of scars after harvest of the temporoparietal fascial flap depending on the design of the skin incision.

The authors evaluated the conspicuousness of the temporal scar caused by two incision patterns after harvesting the temporoparietal fascial flap: a straight incision and a zigzag incision. The 27 scars of 27 patients were examined in this study. Fifteen patients underwent a straight incision and 12 patients had a zigzag incision. This study showed that the zigzag incision resulted in more conspicuous scars than the straight incision and that this effect was more evident in younger patients than in older patients, at least in Japanese. In a comparison of older patients and younger patients irrespective of the skin incision patterns, the scars were substantially more conspicuous in the younger patients. A simple and short incision is preferred when harvesting the temporoparietal fascial flap and more careful management is required for young patients.

Adolescent↗
PubMed2002

Penile reconstruction for extramammary Paget's disease.

The authors report their experience of an extremely rare case of extramammary Paget's disease presenting a deformational change of the penis, which required penile reconstruction after tumor resection. Tumor cells had invaded the dermis beyond the basement membrane of the epidermis. Tumor cells were found at the epithelium of the urethra, but had not invaded the corpus cavernosum. However, fibrotic changes were found in the corpus cavernosum. More than half the length of the penis was resected. Penile reconstruction was performed using a free sensory radial forearm flap. The defects in the mons pubis, scrotum, and the remaining corpus cavernosum were covered using a meshed split skin graft or sheeted split skin graft. Ten months after the operation, the tumor had not recurred and no metastasis was found. The urinary stream was narrow compared with that of a healthy man, but urinary voiding had not been disturbed. Sensory recovery was 12 mm with the two-point discrimination test at the distal end of the reconstructed penis.

Aged↗
PubMed2002

Hard palate mucosal grafts for defects of the nail bed.

The authors present 2 children in whom a hard palate mucosal graft was used for a defect of the nail bed after resecting subungual exostosis. After the tumor was resected with the overriding nail bed, hard palate mucosa without periosteum was grafted to the nail bed defect. In both patients the graft took completely, and within 2 weeks after the operation the patients were able to enjoy activities of daily life, including athletic movement, without any symptoms. Nail growth was uneventful and was complete in 4 or 5 months after the operation without any complications. The authors think that a hard palate mucosal graft is a valid choice for a defect of the nail bed, and the mucosa does not need to be harvested with periosteum. The grafting of hard palate mucosa without periosteum to a defect of the nail bed contributes to a shorter healing time, resulting in a reduction in the period of restriction of movement in activities of daily life, and this is a great advantage in children.

Adolescent↗
PubMed2002

Preshaped hydroxyapatite tricalcium-phosphate implant using three-dimensional computed tomography in the reconstruction of bone deformities of craniomaxillofacial region.

We prepared solid life-sized models and templates of implants based on three-dimensional computed tomography data in six cases with a bone deformity of the craniomaxillofacial region. After simulation surgery using these models and templates, the preshaped hydroxyapatite-tricalcium phosphate (HAP-TCP) implants were prepared to fill in the facial bone defects, and implantation was performed. Consequently, implants fitted the individual bone defects, and satisfactory facial contouring was obtained in five cases. In one case with severe cutaneous scarring in the grafted site, it was necessary to reduce the volume of the preshaped HAP-TCP implant during surgery. In conclusion, the three-dimensional, solid, life-sized model and template are useful for preoperative detailed simulation, and the use of preshaped HAP-TCP implants based on the template probably contributes to successful reconstruction of complex facial bone deformities and to the reduction of surgical invasion, resulting in achievement of better results.

Adult↗
PubMed2002

Cranial remodeling to treat craniosynostosis by gradual distraction using a new device.

OBJECT: The authors describe their experience in remodeling the shape of the cranium in children with craniosynostosis by using gradual distraction. In half of the cases, a new distraction device developed by the authors was used. METHODS: Twenty children with craniosynostosis underwent frontoorbital advancement and cranial remodeling assisted by gradual distraction. There were five children with brachycephaly, two with oxycephaly, five with scaphocephaly, two with plagiocephaly, one with combined scaphocephaly and plagiocephaly, and five with trigonocephaly. Four cases were syndromic and 16 were nonsyndromic. The patients ranged in age from 3 to 50 months (mean 14.5 months) at the first surgery. Simulated surgery was first performed on a three-dimensional solid model made of polyurethane, which accurately represented cranial flexibility, to determine the most favorable osteotomy line. Distraction was initiated 1 week postoperatively. The speed and extent of advancement (maximum extension 45 mm) were predetermined on the basis of previously reported criteria and the results of simulated surgery. Postoperatively, the cranial configuration was favorable in all cases. Spontaneous remodeling of irregularities and/or gaps apparent after distraction was found to occur 2 to 5 months after removal of the distraction devices, especially in patients with trigonocephaly or scaphocephaly. No major perioperative complication was observed in any patient. There were minor complications in six of the first 10 cases, including exposure of the device, shaft slippage, and fluid discharge. A new device was developed and used on the last 10 patients treated; it successfully eliminated device exposure and shaft slippage. A 3-year follow-up review confirmed that there was no relapse of advanced bones. CONCLUSIONS: Highly satisfactory results were achieved in cases of both syndromic and nonsyndromic craniosynostosis when gradual distraction was performed.

Bone Remodeling↗
PubMedDate not supplied

Correction of bone deformity after resection of dermoid cyst using artificial dermis implantation.

We report cases of the dermoid cyst patients with a bone deformity that were treated with artificial dermis implantation. After resecting the tumor, three or five sheets of artificial dermis (Terudermis, Terumo Co. Ltd, Tokyo, Japan) are placed into the depressed site in order to create symmetrical surface with the contralateral side. Neither of the cases presented here showed allergic or infectious reaction during postoperative follow-up period. In both cases, the texture of the implanted region is almost the same as the contralateral side and is almost symmetrical. We believe that artificial dermis may be a useful implantation material to correct depressions in the patient with dermoid cysts.

Adolescent↗
PubMedDate not supplied

Usefulness and limitations of artificial dermis implantation for posttraumatic deformity.

We have previously reported the use of artificial dermis implantation to cover exposed major vessels and to correct a depressed region after tissue resection and bone deformity with satisfactory results. In this paper, we present cases with depressed lesions and adhesive lesions after trauma, treated with artificial dermis implantation. Artificial dermis (Terudermis, Terumo Co. Ltd., Tokyo, Japan) was implanted in 12 cases of posttraumatic deformity. Eight of the 12 cases involved a depressed lesion, and the other four involved adhesive lesions. There was no postoperative infection or allergic reaction in any of the patients. Improvement of the deformity was obtained in all cases, but the degree of volume reduction in traumatic cases is likely to be more severe than that in the non-traumatic cases previously reported. In conclusion, artificial dermis implantation is an easy, safe, and useful method to correct a posttraumatic deformity, such as a depression or an adhesion, although it is important to note that depressions require overcorrection in order to obtain satisfactory results, as compared with non-traumatic cases treated with artificial dermis.

Adult↗