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Biomedical subjects

U Haramoto

Publications and source records attributed to U Haramoto.

15 recordsLinked to original sources
PubMed2001

Anatomic study of the insertions of the levator aponeurosis and Müller's muscle in Oriental eyelids.

To clarify the detailed anatomy of the insertions of the levator aponeurosis and Müller's muscle, 10 upper eyelids of 5 fixed Japanese cadavers were examined. The eyelids were dissected in a manner that the authors devised to disclose the delicate pretarsal structures in close proximity. After removing the orbital roof and fat, they divided the levator aponeurosis at the origin and dissected along its posterior aspect up to the upper tarsal area. The dissected eyelids were evaluated grossly and histologically with a special staining technique. Gross and histological examinations revealed that the dense collagenous levator aponeurosis was transformed distally into fine elastic fibers, which inserted into the pretarsal orbicularis layer. They also found a distinct fascia covering the anterior aspect of the tarsus that continued proximally to Müller's muscle. Conclusively, the levator aponeurosis has no direct collagenous insertion into the tarsus, but is connected mainly to the pretarsal tissue via fine elastic fibers. A fibrous tissue covering the anterior aspect of the tarsus is not the levator aponeurosis, but an extension of Müller's muscle.

Aged↗
PubMed2000

Involvement of keratinocyte activation phase in cutaneous graft healing: comparison of full-thickness and split-thickness skin grafts.

BACKGROUND: Little is known about keratinocytic activation in the graft take and healing process. OBJECTIVE: To investigate the clinical and molecular differences between pure epidermal sheet graft (PESG), split-thickness skin graft (STSG), and full-thickness skin graft (FTSG). METHODS: Three different thickness skin grafts (PESG, STSG, and FTSG) were performed onto three kinds of porcine wounds: shallow, deep, and full. Graft take, contraction, and Ki-67 and beta1 integrin expression in epidermis were studied. RESULTS: All grafts took well. As expected, full wounds covered by PESG and STSG contracted more than those covered by FTSG, whereas shallow wounds covered by FTSG contracted more than those covered by STSG. No difference in contracture was observed among deep wounds covered by PESG, STSG, and FTSG. Up-regulation of Ki-67 and beta1 integrin expression was greater in PESG and STSG, compared with little expression in FTSG. CONCLUSION: The keratinocytic activation phase may occur both in the STSG and PESG healing process, as well as serum imbibition, inosculatory, and revascularization phases.

Animals↗
PubMed2000

A new technique for the treatment of syndactyly with osseous fusion of the distal phalanges.

In treating complex syndactyly of the hand, including bony union of varying degrees, how to cover the exposed bone surface is still disputable. The authors adopted a homemade device for the treatment of a case of syndactyly with terminal bony union. External tissue expander theory was applied to their device, and expansion of the cutaneous bridge was followed by division of the fused distal phalanges. Two months later the raw bone could be covered simply with the expanded local skin, and no skin graft was needed except for at the base of the affected fingers. This technique produces good cosmetic results of the fingertips and nail grooves without secondary deformities.

Humans↗
PubMed2000

Philtral construction by composite skin-muscle rotation and orbicularis oris muscle advancement in secondary cleft lip deformity.

The authors describe a method of philtral construction in a secondary cleft lip deformity to achieve better philtral definition and natural lip animation. The operation begins with a skin incision based on the usual design of secondary revision. Subcutaneous undermining is then performed laterally, and medially up to the line of the new philtral ridge, where the lip is divided vertically to the mucosa. A wedge-shaped flap is developed in the medial lip by dissecting from the posterior mucosal wound edge toward the cutaneous midline up to the dermis. The composite skin-muscle flap is thus elevated and rotated 90 deg on the axis of the cutaneous midline to form the philtral ridge. The orbicularis oris muscle is reapproximated in the midline by advancing the lateral orbicularis segment. The wedge-shaped flap is placed over the advanced orbicularis, and the skin is closed. Ten consecutive patients, followed for more than 6 months, were evaluated. In all patients the lip showed a well-defined philtrum with sufficient thickness and smooth continuity. Natural lip animation was also reproduced. Purportedly, the composite skin-muscle rotation provides a well-defined philtrum, and the midline approximation of the orbicularis muscle provides natural lip animation.

Adolescent↗
PubMed1998

Free flap transfers for the treatment of osteomyelitis of the lower leg.

Since 1974, 31 cases of soft tissue defects associated with osteomyelitis of the lower leg have been treated by free flap transfer and followed up for more than three years. Four patients developed recurrences. Two of them were reoperated on and healed well. One patient was reoperated on three times, but remained infected. One patient developed a fever, but improved after intravenous infusion of antibiotics. Of the eight patients who underwent vascularised muscle transfer to the dead space created by saucerisation of the osteomyelitis, none developed signs of recurrence. By contrast, the four patients who developed recurrences were those in whom the dead space could not be completely filled with the free flap. It therefore seems important that after saucerisation, well-vascularised soft tissue should be used to pack the dead space completely to prevent recurrence of the osteomyelitis.

Adolescent↗
PubMed1998

Avoiding ectropion by using the Mitek Anchor System for flap fixation to the facial bones.

The application of the Mitek Anchor System for bony fixation of the flap in the cheek area is described. The cervicofacial rotation-advancement flap is fixated to the malar bone using Mini Anchors for the purpose of diminishing the downward traction on the lower eyelid. They reduced the tension in the distal part of the flap and avoided distal-edge necrosis and ectropion. In another patient the free vascularized musculocutaneous flap, which had been grafted previously for a surgical defect in the cheek and resulted in ectropion of the lower eyelid, was fixated to the malar bone, and the ectropion was corrected. The Mitek Anchor System is useful in flap fixation to the bone because it provides a simple, fast, and reliable method for flap fixation with minimal dissection and precise placement.

Adolescent↗
PubMed1998

Endoscopic management of subcutaneous gunshot wound with irrigation technique.

The application of the endoscope to the treatment of gunshot wounds has never been reported to our knowledge, with the exception of the laparoscope and the sigmoidscope in abdominal gunshot wounds. We report a patient with a subcutaneous gunshot wound who was treated endoscopically using the irrigation technique. The patient was a 25-year-old man who had been shot in the upper arm. The bullet was found near the thoracic spine via radiograph. At surgery the endoscope was inserted into the wound and irrigation was started. Excellent views could be obtained by irrigation, and the endoscope was advanced along the path of the bullet. The bullet and several fragments were removed with two additional small incisions. The method described herein seems beneficial in that (1) it is less invasive than conventional surgical debridement with a long incision, (2) it may provide information helpful in diagnosing the condition and the location of the bullet and its path, and (3) saline irrigation may have a cleansing effect.

Adult↗
PubMed1996

Correction of the hypoplastic nasal ala using an auricular composite graft.

Auricular composite grafts were used to augment both nasal alar size and thickness in 8 patients who had alar hypoplasia. The grafts included large amounts of conchal cartilage and a small amount of elliptically shaped retroauricular skin. The width of the skin harvested was about one-third that of the harvested cartilage. The cartilage was used to augment the thickness and correct the shape of the ala, and the skin that was grafted to the alar groove was used to restore the covering defect. All grafts took perfectly and the aesthetic results were satisfactory except in 1 patient. The grafted skin provided both a good color and texture match for the nose, and the cartilage maintained the alar shape. This procedure is simple to perform and yields good results with minimal donor site deformities.

Adolescent↗
PubMed1995

Hemifacial hyperplasia with meningeal involvement: a variant of proteus syndrome?

We report on a sporadic case of hemifacial hamartomatous hyperplasia. The patient is male, and has sebaceous nevus-like skin change, subcutaneous lipomatous mass, cranial bone hyperplasia, and bony change of meninges. His lesion involves the anterior half of the face and cranial base, and, medially, is delimited by the midline. No case has been found identical to this in the literature, particularly with respect to the unusual meningeal lesion. However, without this meningeal lesion the rest of the manifestations are not uncommon in Proteus syndrome. Also, this case may be an indication of somatic mosaicism, lethal in its nonmosaic state. Thus, this case may be thought of as a variant of Proteus syndrome.

Adolescent↗