Hemophilia B diagnosed by hematoma at the columella base.
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Child, Preschool↗
Biomedical subjects
Satoshi Yurugi
Publications and source records attributed to Satoshi Yurugi.
Perforating pilomatricoma on the upper eyelid.
We report a rare case of perforating pilomatricoma. A 50 x 40-mm oval nodule, with a whitish scale on its tip, developed on the left upper eyelid of a 43-year-old Japanese woman. There was no history of injury to the left upper eyelid. Histologic examination revealed typical microscopic features of pilomatricoma. In addition, however, an interesting phenomenon was observed: a portion of the tumor mass had extruded from the upper dermis to the skin surface through a perforating epidermal channel in the middle of the tumor. These findings are consistent with the diagnosis of perforating pilomatricoma.
Adult↗
Chronic expanding hematoma in the temporal region.
We report a rare case of chronic expanding hematoma in the right temporal region that developed into a large mass during 12 years. The patient, who had a history of blunt trauma in her right temporal region at the age of 4 months, noticed a slowly growing mass at the same site in the last few months. Computed tomography revealed a well-circumscribed subcutaneous tumor. The tumor was completely resected. Histopathologically, this tumor was confirmed in the diagnosis of chronic expanding hematoma.
Capillaries↗
Use of plastic baskets for rat anesthesia.
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Anesthesia↗
Histological evaluation of grafted hard palate mucosa in the reconstruction of the upper eyelid.
We have used a hard palate mucosal graft for reconstruction of the posterior lamella of the eyelid and in only one case was replacement required because of discomfort and pain. The stratum corneum of the hard palate mucosa may have been the cause.
Adult↗
Chronic expanding hematoma in the temporal region.
A rare case of chronic expanding hematoma in the right temporal region that developed into a large mass over the course of 12 years is reported. The patient, who had a history of blunt trauma to her right temporal region at the age of 4 months, noticed a slowly growing mass at the same site over the last few months. Computed tomography revealed a well-circumscribed subcutaneous tumor. The tumor was completely resected. Histopathologically, the diagnosis of chronic expanding hematoma was confirmed.
Child↗
The use of calcium phosphate cement paste for the correction of the depressed nose deformity.
The authors report the use of calcium phosphate cement paste as a material for correction of depression after nasal bone fracture, and evaluate its usefulness. Biopex R (Mitsubishi Material Corporation, Tokyo, Japan) was used in this study as calcium phosphate cement (CPC), which was developed in Japan. CPC injection was used in six patients (four women and two men) with depressed nose deformity after nasal bone fracture. The patients' ages ranged from 29 to 67 years (mean, 49 years), and the follow-up period ranged from 12 to 27 months. The amount of injected cement varied from 0.5 to 2.5 mL, approximately. There was no postoperative infection or allergic reaction in any patient. Clinical and X-ray photography findings showed that a reduction in volume of the injected cement occurred gradually as long as 7 to 8 months after surgery. After that period, the volume was mostly maintained. It seemed that the degree of reduction was approximately 10% to 15% of the original volume. Satisfactory results were obtained in all cases. The authors conclude that the use of CPC is an option for the correction of depressed nose deformity and that its application must be determined in each case, considering its advantages and disadvantages.
Adult↗
Mortality and recurrence rate after pressure ulcer operation for elderly long-term bedridden patients.
We operated on 16 sacral pressure ulcers in elderly and long-term residential patients who were immobile as a result of cerebral vascular disease. The mean age of patients was 76 years. Eight ulcers were treated with local fascial flaps and 8 by simple closure. The follow-up period was from 1 to 4 years. Recurrence and mortality rates were examined retrospectively. In the 16 patients, recurrence occurred in 37.5%, and 43.8% died without recurrence. The recurrence rate was 37.5% for local fascial flaps and 37.5% for simple closure. Overall mortality was 68.8% in the follow-up period. Because postoperative death was common, we should not only focus on reducing local pressure but also pay attention to any underlying disease. Because of this high mortality rate, the least invasive procedure possible should be used. Because the recurrence rate of simple closure was the same as for local fascial flaps, simple closure should be considered as a reconstructive method.
Age Factors↗
Lymphoma of mucosa-associated lymphoid tissue (MALT) arising in the parotid gland.
Malignant lymphoma of the parotid gland is a rare condition. The authors present the case of a 59-year-old woman with primary malignant lymphoma arising from the parotid gland, in which they resected the tumors and surrounding lymph nodes. Histopathologic examination of the tumor demonstrated a lymphoma of mucosa-associated lymphoid tissue (MALT). Chemotherapy and radiotherapy were performed after surgery. The clinical manifestation, treatment, and postoperative course are described.
Female↗
Adult umbilical hernia with vertical dislocation.
We present a case of adult umbilical hernia with vertical dislocation along the abdominal wall. The hernial sac arose from the internal ring and connected to the umbilicus 20 mm below the internal ring. The postoperative course was uneventful. Two years and four months after the operation there was no evidence of recurrent hernia even when abdominal pressure was increased, and the umbilicus looked acceptable. An umbilical hernia is usually within the umbilicus. The hernial sac arose from the internal ring so should be called an umbilical hernia not an epigastric hernia. It is unusual that the umbilical hernia dislocates vertically along the abdominal wall, while the umbilicus stays depressed. This atypical form of umbilical hernia has not been described previously as far as we know.
Aged↗
Expression of alpha, beta, and gamma catenins in vascularized and nonvascularized nerve grafts during the regeneration process.
The authors investigated the expression of three kinds of catenins (alpha, beta, gamma) in vascularized and non-vascularized nerve grafts, using the rat sciatic nerve model. The vascularized nerve, 15 mm in length, was elevated with its nutrient vessels in the left hindlimb of rats. In the right hindlimb, a 15-mm segment of the sciatic nerve was elevated (resected) without the nutrient vessels as a non-vascularized nerve. Both nerves were sutured to the original site. At various periods up to 14 weeks after operation, the entire graft was removed. Expression of three catenins was detected by Western blot analysis and histochemical staining, using the antibody to each catenin. The level of beta catenin increased during nerve regeneration in both the vascularized and non-vascularized grafts, while the level of alpha and gamma catenins did not increase in both grafts. There was no difference in the level of the three catenins between the two methods of nerve grafting. Histochemical findings showed that at the 4th and 14th postoperative weeks, alpha and gamma catenins were stained diffusely in both grafts, while beta catenin was stained around the regenerating axons in both grafts. The degree of beta catenin was greater in the 4th postoperative week than in the 14th postoperative week, but no obvious difference in the degree of staining of the three catenins between two grafts was found. These results suggest that beta catenin may play a different role from alpha and gamma catenins in nerve regeneration, and that the expression of these catenins is not influenced by vascularization of the nerve graft.
Animals↗
Distortion and movement of the expander during skin expansion.
Distortion and movement of tissue expanders can cause expansion of the wrong area, such as the naevus or the scar that is to be resected. In 71 rectangular expanders, we examined the incidence of distortion (over 15 degrees) and movement (over 3 cm). We divided the expanders into three anatomical site groups: scalp, body, and extremities, and compared the complication rate between two study groups (distortion or movement, or not). In total, the incidence of distortion was 15/71 (21%) and that of movement 5/71 (7%). Distortion occurred mainly in the extremities (11/33,33%). The implanted expanders tended to move more often in the body part (3/15, 20%). In the extremities, the bigger the angle between the axis of the implanted expander and that of the extremity, the bigger the angle of distortion. Although the incidence of complications between the two groups was not significant, except for alteration in design of the flap, we recommend that these points should be considered when preoperative plans are being made for appropriate patients.
Adolescent↗
Influence of periosteum on donor healing after harvesting hard palate mucosa.
The authors report the influence of periosteum on healing of palatal defect based on more than 10 years of experience of harvesting hard palate mucosa. Between June of 1991 and May of 2001, the authors harvested 80 hard palate mucosae as graft material for skin and mucosa defects. All grafts were harvested from the center of the hard palate. Patients ranged in age from 10 to 82 years old. Of 80 mucosae, 54 were harvested with periosteum, and periosteum was not retained in the defect bed. The other 26 mucosae were harvested without periosteum, which was therefore retained in the defect bed. The healing time increased depending on the defect size in both groups of patients retaining and not retaining periosteum. There was a significant relationship between the defect size and healing time in both groups (Spearman's rank correlation test, p < 0.0001 in both groups). In the two groups, there was no significant relationship between patient age and healing time in the patients with defect smaller than 1.99 cm or larger than 2.00 cm2. There were no significant differences in the rate of patients with pain and bleeding between the groups retaining and not retaining periosteum. In the group not retaining the periosteum, all 54 patients showed a flat or atrophic smooth surface at more than 6 months after epithelization and had no discomfort. However, 17 patients showed flat or atrophic smooth surface in the group retaining the periosteum and the remaining 9 patients showed hypertrophy at more than 6 months after epithelization, with accompanying discomfort. The rate of the patients with hypertrophy in the group of patients retaining periosteum was significantly high as compared with that in the group of patients not retaining periosteum (p = 0.000013, Fisher's exact test). In 26 patients retaining periosteum, the age of the patients with hypertrophic surface was significantly younger than that of the patients with flat or atrophic surface (p = 0.0010, Welch's -test), and the defect size in the patient with hypertrophic surface was significantly smaller than that of the patients with flat or atrophic surface (p = 0.0028, Welch's t-test). In conclusion, our study demonstrated that the existence of periosteum in the palate donor bed does not contribute to reduced healing time or reduced pain. Rather, retaining the periosteum caused hypertrophy of the donor site, leading to discomfort, especially in young patients with a comparatively small defect.
Adolescent↗
Hard-palate mucosal graft in the management of severe pincer-nail deformity.
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Adult↗
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↗
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↗
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↗
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↗