Hideaki Doi

Long-term immunologic induction of donor-specific tolerance to skin allografts by bone marrow transplant in rabbits

The induction of donor-specific tolerance to skin allografts was investigated in rabbits using bone marrow transplantation techniques reported to be effective in mice. Various routes of bone marrow transplantation (i.e., intravenous, portal venous, or intraosseous) were also examined. In regimen A, the animals were treated with portal venous injection of bone marrow cells from the donor on day 0 and intravenous injection of bone marrow cells from the same donor on posttransplant day 5. In regimen B, the animals were treated with portal venous and intraosseous injections of donor bone marrow cells on day 0 and intravenous injection of bone marrow cells from the same donor on posttransplant day 5. In regimen C, the animals were given intraosseous injection of donor bone marrow cells on day 0 and intravenous injection of bone marrow cells from the same donor on posttransplant day 5. It was found that regimens B and C were more effective than regimen A in prolonging allograft survival. The results demonstrate that induction of allograft tolerance can be achieved by bone marrow transplantation in a rabbit model. This protocol deserves further study in other large animal models.

The Preoperative Use of Extra-tissue Expander for Syndactyly

To our knowledge, this is the first report of a method of stretching the interdigital skin of syndactyly by means of a pincer. The pincer, a U-shaped metal spring plate with a sponge cushion, is applied before the operation for about two months; pressure is placed against both sides of the interdigital fusion to expand the skin and to develop hollows. Use of the pincer facilitates a syndactyly operation by allowing defect coverage with a local flap only. Four patients successfully treated by this method are reported. The method has the great advantage of not requiring skin grafts, which often have unfavorable results both functionally and cosmetically.

A new operative method for treatment of xanthelasma or xanthoma palpebrarum : Microsurgical inverted peeling

A new operative technique for treatment of xanthelasma or xanthoma palpebrarum was introduced. The merits of this technique are (1) no skin excision with the tumor, (2) making the flap from the skin covering the tumor, (3) no need for donor site, (4) no significant cosmetic problem, and (5) reoperation performed by same procedure. Our new technique is performed under local anesthesia. The skin and tumor are raised together just above the orbicularis oculi muscle like a flap. The tumor is peeled piece by piece from the flap using micro-scissors under a surgical microscope. After tumor enucleation is performed, the skin flap without the tumor is sutured back directly. Our new technique was performed for seven cases of xanthelasma. The recurrence of the tumor was seen only in two cases, which were complicated with hypercholesterolemia. No recurrence was observed after a secondary operation and with the use of anti-hypercholesterolemic drugs. Large xanthelasma can be treated by our new surgical technique without extra skin excision with the best possible cosmetic results.

A new malleable self-retaining retractor.

Simple function, wide view, and safety are three important properties of a good retractor. Since conventional retractors are not specifically designated for extraocular or neurovascular operations, particularly on the head and neck, we hereby introduce our self-retaining retractor. This instrument is composed of an ordinary self-retaining retractor and a pair of malleable retractors. This retractor has the previously mentioned properties of a good retractor. We have used this type of retractor for a variety of plastic surgical operations.