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Biomedical subjects

T Tateshita

Publications and source records attributed to T Tateshita.

At least 19 recordsLinked to original sources
PubMed2001

Reconstruction of a full-thickness defect of the chest wall caused by friction burn using a combined myocutaneous flap of teres major and latissimus dorsi muscles.

This report describes the therapeutic course of a case of deep burns caused by friction heat generated over a long contact time by a rotating tractor wheel. The burn was accompanied by a full-thickness defect of the chest wall, which we treated with a combined myocutaneous flap of teres major and latissimus dorsi muscles with a large skin flap. Our therapeutic concept of this case is discussed. Based on the postoperative course of this case, we think a combined myocutaneous flap of teres major and latissimus dorsi muscles with two nourishing vessels as an alternative is a very useful, safe, and secure method for the treatment of cases with axillary damages which require one-stage and stable reconstruction, like our patient.

Accidents, Occupational↗
PubMed2001

Effects of a collagen matrix containing prostaglandin E(1) on wound contraction.

In this study, we evaluated the effectiveness of prostaglandin (PG) E(1) in inhibiting wound contraction, both alone and in combination with collagen matrix, using a in vivo full thickness skin defect model. To clarify the mechanisms involved in this inhibition we also used a fibroblast-populated collagen gel contraction in vitro model. We demonstrated that collagen matrix alone significantly inhibited wound contraction PG E(1) alone did not. Interestingly, their combination was much more effective than either collagen matrix or PG E(1) alone, a finding which was also supported by histopathological examination. Wounds treated with collagen matrix, but not control wounds, showed horizontal rearrangement of collagen fibers in the dermal part as well as evidence of active fibroblast proliferation which was not observed in scar regions surrounded by normal dermis. With the fibroblast-populated collagen gel contraction in vitro model, we found that PG E(1) significantly inhibited contraction at a high dose. It was concluded that collagen matrix combined with PG E(1) is effective for preventing contracture producing so called neodermis than collagen matrix alone, which remains one of the most challenging problems in treating full thickness type wounds.

Alprostadil↗
PubMed2001

Effects of collagen matrix containing transforming growth factor (TGF)-beta(1) on wound contraction.

We evaluated the effectiveness of transforming growth factor (TGF)-beta(1) on wound contraction, both alone and in combination with collagen matrix, using an in vivo delayed wound healing type model. To clarify the mechanisms involved in the effectiveness of TGF-beta(1), we also used a fibroblast-populated collagen gel contraction in vitro model. Although we found that TGF-beta(1) significantly accelerated contraction of the fibroblast-populated collagen gel in vitro, we demonstrated that both collagen matrix alone and 1.0 microg of TGF-beta(1) alone significantly inhibited wound contraction in the in vivo model. In addition, the combination of TGF-beta(1) and collagen matrix was much more effective than TGF-beta(1) alone, a finding which was supported by histopathological examination. Wounds treated with collagen matrix containing TGF-beta(1) showed horizontal rearrangement of collagen fibers in the dermal part as well as evidence of active fibroblast proliferation, which was not observed in the scar regions of controls. These results show that the application of TGF-beta(1) treated collagen matrix is effective for preventing contraction producing so called "neodermis" in treating a delayed healing type model and may be highly beneficial for treating chronic wounds.

Animals↗
PubMed2001

Technique for fixing a temporalis muscle using a titanium plate to the implanted hydroxyapatite ceramics for bone defects.

We devised a technique to fix the temporalis muscle to the transplanted hydroxyapatite implant by using a titanium plate, which is fixed to the hydroxyapatite ceramic implant by screws and achieves good clinical results. The size, shape, and curvature of the hydroxyapatite ceramic implants were determined according to full-scale models fabricated using the laser lithographic modeling method from computed tomography data. A titanium plate was then fixed with screws on the implant before implantation, and then the temporalis muscle was refixed to the holes at both ends of the plate. The application of this technique reduced the hospitalization time and achieved good results esthetically.

Adolescent↗
PubMed2000

Evaluation of a high density polyethylene fixing system for hydroxyapatite ceramic implants.

A fixing system made of high density polyethylene (mini ROC fastener system, Innovasive Devices Inc., Marlborough, MA, USA) was applied to artificially porous hydroxyapatite (HAP) implants. Their fixing ability was assessed with pull-out tests and a preliminary study was done to determine the most suitable drill hole diameter and depth. Effectiveness of the combined use of drill-free titanium screws (Martin GmbH & Co. Ltd., Tuttlingen, Germany) and the mini ROC fastener system was also evaluated. The pull-out strength of the system differed according to the hole diameter and depth of insertion. The strongest physical strength was obtained with holes 2.10 mm in diameter and 6 mm in depth. If inserted under optimum conditions, the mini ROC fastener system was deemed to have adequate fixing ability for clinical applications pull-out strength more than 7 kgf. In addition, the combined use of a drill-free screw for microplate with the mini ROC fastener system had a pull-out strength of around 10 kgf which was superior to the mini ROC fastener system alone. The mini ROC fastener system is best suited to fix HAP implants to the soft tissues such as muscle, tendon or periosteal tissue as well as for plate fixation when used with drill-free screws. The fact that effective fixing was achieved should result in a further increase in the clinical use of artificial HAP implants.

Biocompatible Materials↗
PubMed2000

Phacomatosis pigmentovascularis type IIa successfully treated with two types of laser therapy.

We describe a 28-year-old Japanese woman with phacomatosis pigmentovascularis type IIa who was treated by 27 sessions of Q-switched ruby laser irradiation to the site of dermal melanosis on her face and three sessions of dye laser irradiation to the port-wine stain on her left cheek. This is the first report of the successful treatment of a cutaneous lesion in a patient with phacomatosis pigmentovascularis. As the outcome of the treatments was excellent, we conclude that phacomatosis pigmentovascularis type IIa can be treated successfully by the combination of the two types of laser therapy.

Adult↗
PubMed2000

New surgical technique for macrostomia repair with two triangular flaps.

Our new surgical procedure with two triangular flaps for macrostomia repair allows us to achieve all three therapeutic goals, including formation of symmetric lips and commissures of the mouth, reconstruction of the orbicularis muscle of mouth to restore labial function, and reconstruction of the commissure of the mouth with a natural looking contour. Furthermore, the position of the commissure of the mouth can be adjusted intraoperatively according to the extent of macrostomia. As reported here, our method provides very satisfactory clinical results and is relatively easy to perform. Thus, we believe that our method can serve as a standard for the surgical treatment of macrostomia.

Child, Preschool↗
PubMed1999

Prostaglandin E1 and recombinant bone morphogenetic protein effect on strength of hydroxyapatite implants.

Although combinations of hydroxyapatite (HAP) and bone morphogenetic protein (BMP) are expected to provide potent alternatives to autogenous bone grafts, it is still anticipated that substances that act synergistically with BMP will be found because the inducing potential of purified BMP in bone is not strong enough. We already have shown that prostaglandin (PG) E1 has a strong and dose-dependent synergistic effect on the osteoinductive activity induced by recombinant human (rh) BMP and that it enhances osteoconduction even when used alone. In this study, porous HAP rods were treated as follows: (1) without PGE1 or rhBMP (control group); (2) with varying concentrations of PGE1; and (3) with varying concentrations of PGE1 combined with 1 microg of rhBMP-2. The rods were subperiosteally implanted on the cranial bone of rabbits to evaluate the effect of these treatments on the mechanical strength of the implanted HAP rods. The HAP rods were removed 3, 6, or 9 weeks after implantation and subjected to mechanical strength determinations. The control group (no addition of BMP to the rods) showed no significant increase in three-point bending strength or in compression strength compared to pre-implantation. On the other hand, PGE1 combined with rhBMP had a strong and dose-dependent effect on the mechanical strength of HAP, increasing it significantly, especially compression strength. PGE1 also increased mechanical strength even when used alone. Histological examination revealed that PGE1, whether or not it was combined with rhBMP, increased bone formation into the pores of HAP and consequently increased the mechanical strength of porous HAP.

Alprostadil↗
PubMed1999

Effects of a collagen matrix containing basic fibroblast growth factor on wound contraction.

We evaluated the effectiveness of basic fibroblast growth factor (bFGF) in inhibiting wound contraction, both alone and in combination with collagen matrix, using a simulated in vivo delayed healing type model. We also studied the mechanisms involved in this inhibition in in vitro experiments using fibroblast populated collagen gels. As a result, we were able to demonstrate that both collagen matrix and bFGF significantly inhibited wound contraction; especially, bFGF acted in a dose-dependent fashion. Interestingly, their combination was much more effective than either collagen matrix or bFGF alone, a finding that was supported by the histopathological data. Wounds treated with collagen matrix, but not control wounds, showed horizontal rearrangement of collagen fibers in dermis as well as evidence of fibroblast proliferation, which was not observed in scar regions surrounded by normal dermis. Using fibroblast-populated collagen gel contraction as an in vitro model, we found that bFGF significantly inhibited contraction. Taking all these results together, it was concluded that collagen matrix is useful not only as a carrier of cytokines such as bFGF, but also for the quick closure of chronic wounds, thereby preventing contracture, which remains one of the most challenging problems in treating this type of wound. Application of bFGF-treated collagen matrix to chronic wounds such as decubitus, and diabetic and leg ulcers may prove to be highly beneficial in clinical practice.

Animals↗
PubMed1999

Porous hydroxyapatite ceramics and their ability to be fixed by commercially available screws.

We developed porous hydroxyapatite ceramics (HAP) which are screw fixable and evaluated the fixing abilities of commercially available screws using pull-out tests with the HAP implants. The fixing abilities were higher in the following order: Leibinger micro PLUS titanium screw > Osteomed M3 titanium screw > Leibinger standard mini screw > Martin-drill free screw. In preliminary examinations, the fixing ability of each of the screws differed according to the hole diameter and depth of insertion but if inserted under optimum conditions, all were deemed to have adequate fixing ability for clinical applications. Therefore, screw systems are superior for fixing HAP implants to surrounding bone than the use of thread or wire. Specifically, Leibinger's micro PLUS titanium screws system seems to be a good option currently. The fact that effective fixation was achieved should result in a further increase in the clinical use of synthetic porous HAP implants whose porosity and pore size are completely controlled for those purposes.

Analysis of Variance↗
PubMed1999

One-stage reconstruction of microtia in microform.

We treated five patients with auricular deformities (microtia in microform and group IIB or III constricted ears) using the following procedure: nearly all of the contralateral conchal cartilage was resected, grafted, and sutured to supplement a cartilaginous deficit and to keep the supporting frame of conchal cartilage expanded by the double banner flap method. After this, a soft tissue deficit was reconstructed by our newly developed method of covering the defect with a triangular flap superior to the auricle by making a skin incision and a rhomboid flap anterior to the auricle. So far, we have obtained satisfactory results using this one-stage procedure.

Child↗
PubMed1999

Treatment of large complex cranial bone defects by using hydroxyapatite ceramic implants.

Hydroxyapatite ceramic implants were used in the reconstruction of very large and complex-form cranial bone defects in nine patients. The bone defects were the result of craniectomy after infections and other complications such as severe brain edema, after neurosurgery, and as a result of trauma, subdural hemorrhage, and surgery for brain tumor. The size, shape, and curvature of the hydroxyapatite ceramic implants were determined based on high-precision, full-scale models fabricated through a laser lithographic molding method by using computed tomographic data. The use of this method allowed the fabrication of hydroxyapatite ceramic implants of shapes that accurately matched the area of bone defect, allowing for a minimum of adjustment during the operation even with a complex-form implantation. Not only were good cranial contour reconstructed and aesthetically satisfactory results obtained in the cases treated by incorporating this series of techniques, but neurologic conditions present in some cases were also improved to some extent. The postoperative course has been steady for all nine patients, with no blood transfusions required during or after the operations and no implants requiring removal because of infection or other postoperative complications. The average length of postoperative hospitalization for the nine cases was 11.7 days, remarkably short considering the clinical conditions.

Aged↗
PubMed1998

Determinations of strength of synthetic hydroxyapatite ceramic implants.

To study the physical strengths of various types of synthetic high porosity hydroxyapatite plates, we constructed samples of a fixed shape, 8 X 25 mm in size, with varying degrees of thickness (3 to 10 mm) and porosity (40, 50, and 60 percent), as well as samples with varying degrees of curvature and samples constructed with computer-aided design-computer-aided manufacturing (CAD-CAM) technology based on a real-size model made with laser lithography from computed tomography data. The strength of the samples was studied with the three-point bending test and crush tests. Studies showed that strength decreases with increasing porosity and increases with increasing thickness. In addition, results of testing plates of varying shapes and degrees of curvature revealed that the effects of these variations were small and that when the width and thickness were held constant, changing the curvature of the entire unit (from a height of 20 to 30 mm) or altering both sides had no remarkable effect on strength. On the other hand, strength testing of plates of various shapes and thicknesses constructed from clinical computed tomography data revealed that minimum optimization of the parameters was achieved when plates had a porosity of about 40 percent and a thickness of about 8 mm.

Biomechanical Phenomena↗
PubMed1998

Efficacy of the ruby laser in the treatment of Ota's nevus previously treated using other therapeutic modalities.

Ruby laser treatment, especially with a Q-switched laser, is remarkably effective for Ota's nevus, although a wide variety of other therapeutic modalities have had limited success. Consequently, laser treatment is now considered the treatment of choice. However, for Ota's nevus previously treated with dry ice cryotherapy (carbon dioxide snow), dermabrasion, free skin grafting, or other methods, therapy is still a challenge, even with the ruby laser. In this study, 14 patients with Ota's nevus previously treated using other modalities were treated using a Q-switched ruby laser. Eight patients previously underwent dry ice cryotherapy, three patients underwent free skin grafting, two patients underwent dermabrasion, and one patient received a cosmetic tattoo. The study group was composed of five male and nine female patients. The ages of the patients at the start of treatment ranged from 5 to 62 years. We concluded, based on the findings of this study, that Q-switched ruby laser therapy can provide favorable results even with lesions previously treated by other therapeutic modalities, provided that the treatment sessions are repeated more frequently and over a longer period of time than those used for untreated lesions and that they are combined with plastic surgical techniques such as scar resection or local flaps.

Adolescent↗
PubMed1997

Reconstruction of defects of the entire vermilion with a buccal musculomucosal flap following resection of malignant tumors of the lower lip.

We reconstructed a defect of nearly the entire lower vermilion using a buccal musculomucosal flap following resection of a malignant tumor of the lower lip and obtained satisfactory results. The buccal musculomucosal flap was semi-spindle shaped and pedicled at the angle of the mouth. A flap measuring as much as 1.5 cm in width and 5 cm in length could be raised while ensuring that fibers of the buccinator muscle extended over its entire length. Using this technique, it was possible to reconstruct a wide defect following tumor resection and removal of almost the entire lower vermilion by means of only a transposition of a unilateral buccal musculomucosal flap after about one-quarter of the lower lip had been excised and sutured primarily. Reconstruction with this technique is a two-stage operation, and a secondary minor touch-up operation is performed on the angle of the mouth at the same time as repair of the dog-ear of the pedicle. Advantages of this technique are that food can be taken orally soon after the operation, hemodynamics in the flap are maintained stably because the flap contains fibers of the buccinator muscle, and the vermilion is given a natural eminence. In addition, postoperative drooling is minimized, and sensation returns to the vermilion within the early postoperative period. Based on these advantages, we think our technique should be the first choice for carrying out reconstruction of defects that are located mainly in the lower lip vermilion because this is a safe and reliable method with which we performed 12 cases of vermilion reconstruction without flap necrosis and with satisfactory aesthetic and functional results.

Aged↗
PubMed1996

Clinical effectiveness of an ointment containing prostaglandin E1 for the treatment of burn wounds.

This report discusses the effectiveness of conservative treatment of burns using applications of prostaglandin E1 (PGE1) containing ointment (PGE1 ointment) to the wound site. Fourteen patients with superficial dermal burns (SDB), deep dermal burns (DDB) and full-thickness dermal burns (DB), who were treated with repeated applications of this ointment, showed rapid epithelialization of the affected tissue. Hypertrophic scarring after epithelialization was less than that expected after other therapies. The degree of scarring was graded as 'none', 'mild', 'moderate' or 'severe'. The results of this therapy revealed no scarring in two sites (8.7 per cent), mild scarring in 16 sites (69.6 per cent), moderate scarring in one site (4.3 per cent) and severe scarring in four sites (17.4 per cent) out of 23 sites distributed among the patients. The application of PGE1 ointment in combination with skin grafting surgery was found to improve functional and aesthetic results in the patients with DDB and DB, by minimizing the area of the donor site; it was especially useful for children with extensive burns because of the shortage of available tissue as donor site material for skin grafting.

Administration, Topical↗
PubMed1996

An operation for Stahl's ear.

We devised an operation to correct Stahl's ear, a rare but difficult to treat auricular malformation. First, a wedge excision is made of the anterior skin and cartilage of the abnormal, third crus prominence. The abnormal, flat part of the helix is excised. A conchal cartilage graft is used to support the area after closure of the defect, including advancement of the helical edges. The procedure has been used in five cases with satisfactory results.

Child, Preschool↗