Motomu Maeda

Microvascular anastomosis using polyethylene glycol 4000 and fibrin glue.

Rat femoral arteries and veins were anastomosed using fibrin glue and a soluble intravascular stent made of polyethylene glycol 4000 (PEG-4000) with a patency rate of 100%. The anastomoses were strong enough to tolerate a pressure of 250 cm H2O. Histological changes at anastomosed sites and toxicity of PEG-4000 were also examined. With this method, an end-to-end anastomosis can be performed easily and quickly.

Congenital ectopic nail of the fifth finger

A case of congenital ectopic nail (onychoheterotopia) of the fifth finger is described.

Modified split V-W plasty for entropion with an epicanthal fold in asian eyelids

Background: The epicanthal fold, which is peculiar to East Asians, forms an arch across the medial canthus in parallel with the nose. It is often accompanied by entropion of the medial eyelid. Although many surgical procedures have been described for correction of the epicanthal fold, none has reported a procedure to treat the epicanthal fold and entropion at the same time. The authors have performed a modified split V-W plasty to simultaneously correct entropion and to modify the epicanthal fold. Methods: From January of 1998 to December of 2002, we have performed a modified split V-W plasty in 20 cases. The preoperative and postoperative medial canthal distances and palpebral fissure width were measured, and the extent of postoperative scarring and improvement of the epicanthal fold and entropion were reviewed. Results: This method provided good results, including an inconspicuous scar, release of the epicanthal fold, and improvement of entropion. Conclusion: The authors believe that the modified split V-W plasty is available to eliminate entropion with an epicanthal fold in Asian eyelids.

Omental transposition and skin graft in patients for advanced or recurrent breast cancer.

Nine patients, including 4 with primary advanced breast cancer (stage IV) and 5 with local recurrent cancer, underwent chest wall reconstruction using an omental flap and mesh skin grafting. In 2 of these patients the defect of bony chest wall was reconstructed with an acryl-resin plate and omental flap. The postoperative course in all patients was uneventful, except for a slight necrosis on the transposed mesh skin. Flail chest or dypsnea did not occur in those with a bony chest wall reconstruction. The immediate postoperative performans status in 6 of 9 patients and also quality of life improved.

A giant calcifying pseudocyst seen in a patient with overlap syndrome.

A case of a female with a large cystic tumor in her infrascapular region is reported. The tumor was 8 cm × 7 cm in size. Histologically, it was a pseudocyst with calcification. The patient showed no abnormal renal functions other than proteinuria. Because she had suffered from overlap syndromes of systemic lupus erythematosus, progressive systemic sclerosis, and suspected dermatomyositis, we diagnosed this as a unique case of dystrophic calcinosis. There have been several reports of cases with connective tissue diseases showing subcutaneous calcification, but to our knowledge no such giant calcifying pseudocyst has ever been reported.

Malignant Hemangioendothelioma in Discoid Lupus Erythematosus

A 51‐year‐old gardener developed malignant hemangioendothelioma in a lesion of discoid lupus erythematosus (DLE) after repeated occurrence of squamous cell carcinoma and keratoacanthoma. The hemangioendothelioma arose in the same DLE lesion where squamous cell carcinoma had appeared. It was treated with surgical exision followed by intraveneous dimethyltriazenoimidazole carboxamide (DTIC). He has not shown any signs of recurrence for a follow‐up period of 45 months. This is the first report, to our knowledge, of the occurrence of malignant hemangioendothelioma in a DLE lesion.

Eight Case Reports of Jejunal Pull-Up with the Aid of Microvascular Anastomosis after the Operation for Thoracic Esophageal Disease

食道再建 に有茎 空腸 を用 いた際 のmicrosurgeryに よ る血行 再建 の有用 性 につ いて検 討 した。過 去9年 間 の有茎 空腸 に よ る食道再建23例 中,血 行 再建 を行 った8例 を対象 と した。 男性6例,女 性2例,年 齢 は52~71歳,原 疾 患 の内訳 は,食 道癌4例,食 道癌 術 後縫合 不全2例,食 道再 発 胃癌1例,腐 食性 食道炎1例 で あっ た。 血行再 建 に は空腸 側 はJ1~J2の 動静 脈 を用 い,吻 合 動脈 は 頸横動 脈5例,内 胸 動脈2例,吻 合 静脈 は外 頸静 脈3例,前 頸 静脈2例,内 胸 静脈2例 であ った。1例 に はJ2~J3の 動静 脈 間 に大伏在 静 脈 を間置 した。 血行 障害 に よ る縫合 不 全 を1例 に認 め た。有 茎 空腸 を用 い た食道 再建 にお い て,microsurgeryに よ る血行 再建 は,症 例 に 応 じて種 々の 対応 が可 能 で,空 腸の 頸部挙 上 と血 流保 持 に有用 で あ った。

Reconstruction of microtia with conchal remnant.

In microtia with conchal remnant (type B microtia), there are various degrees of deformity; consequently, different surgical procedures are required for individual cases. To clarify and simplify these complicated surgical techniques, type B microtia is divided into two types, type BI and type BII, from the standpoint of the emphasis on conchal creation. The methods of treatment are discussed.