start-ver=1.4
cd-journal=joma
no-vol=24
cd-vols=
no-issue=10
article-no=
start-page=566
end-page=571
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2013
dt-pub=20130710
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Vascularized peripheral nerve grafting promotes myelination of regrowing optic nerve
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=We investigated whether the use of vascularized peripheral nerve grafts on the optic nerve stump enhances axonal regeneration of retinal ganglion cells compared with isolated nonvascularized grafts. The rat median nerve was microsurgically sutured with its supplying artery and vein to the optic nerve stump. The number of retinal ganglion cells with regenerating axons was evaluated by retrograde labeling into the grafted peripheral nerve, and the myelination of the regenerating axon fibers was examined by electron microscopy. The number of retinal ganglion cells with regenerating axons was significantly higher in the vascularized graft than in the nonvascularized graft. The ratio of myelinated axon fibers was also increased in vascularized grafts. Thus, grafting with their supplying arteries and veins to an injured nerve stump represents a promising strategy to accelerate axonal regeneration from neurons of the central nervous system.
en-copyright=
kn-copyright=
en-aut-name=KomatsuSeiji
en-aut-sei=Komatsu
en-aut-mei=Seiji
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=WakabayashiTaketoshi
en-aut-sei=Wakabayashi
en-aut-mei=Taketoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=YamadaKiyoshi
en-aut-sei=Yamada
en-aut-mei=Kiyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=MatsumotoKumiko
en-aut-sei=Matsumoto
en-aut-mei=Kumiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=KimataYoshihiro
en-aut-sei=Kimata
en-aut-mei=Yoshihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=KosakaJun
en-aut-sei=Kosaka
en-aut-mei=Jun
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
affil-num=1
en-affil=
kn-affil=Okayama Univ, Grad Sch Med, Dept Plast & Reconstruct Surg
affil-num=2
en-affil=
kn-affil=Okayama Univ, Grad Sch Med, Dept Cytol & Histol
affil-num=3
en-affil=
kn-affil=Okayama Univ, Grad Sch Med, Dept Plast & Reconstruct Surg
affil-num=4
en-affil=
kn-affil=Okayama Univ, Grad Sch Med, Dept Plast & Reconstruct Surg
affil-num=5
en-affil=
kn-affil=Okayama Univ, Grad Sch Med, Dept Plast & Reconstruct Surg
affil-num=6
en-affil=
kn-affil=Kansai Med Univ, Dept Anat & Cell Sci
en-keyword=graft
kn-keyword=graft
en-keyword=microsurgery
kn-keyword=microsurgery
en-keyword=optic nerve
kn-keyword=optic nerve
en-keyword=retinal ganglion cells
kn-keyword=retinal ganglion cells
en-keyword=Schwann cells
kn-keyword=Schwann cells
en-keyword=vascularized nerve
kn-keyword=vascularized nerve
END
start-ver=1.4
cd-journal=joma
no-vol=8
cd-vols=
no-issue=4
article-no=
start-page=e2797
end-page=
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2020
dt-pub=202004
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Utilization of a Simple Surgical Guide for Multidirectional Cranial Distraction Osteogenesis in Craniosynostosis
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Background: Multidirectional cranial distraction osteogenesis (MCDO) can achieve a desired shape for deformities of the cranium. In the past, visual estimation was used to reflect on the actual skull, but it was time-consuming and inaccurate. Here we demonstrate an effective osteotomy navigation method using surgical guides made from a dental impression silicone.
Methods: Seven patients who underwent MCDO between August 2013 and September 2016 were included in the study. Five cases involved utilization of the surgical guide for osteotomy. Three-dimensional (3D) printed cranium models were made using 3D computed tomography (3DCT) imaging data and dental impression silicone sheets were molded using the printed cranium models. These surgical guides were sterilized and used for intraoperative osteotomy design. Vertical distance between nasion/porion and osteotomy lines were calculated using 3D printed cranial models and postoperative 3DCT images to assess reproducibility.
Results: The average surgical time/design time was 535/37.0 minutes for the nonsurgical guide group and 486.8/11.8 minutes for the surgical guide group (SG). Treatment using the surgical guide was significantly shorter in terms of operative time and time required for design. For the vertical distance comparison, the average distance was 5.7mm (SD = 0.3) in the non-SG and 2.5mm (SD = 0.44) in the SG, and SG was more accurate.
Conclusions: Shorter operative times and higher reproducibility rates could be achieved by using the proposed surgical guide, which is accurate, low-cost, and easily accessible.
en-copyright=
kn-copyright=
en-aut-name=MatsuiChihiro
en-aut-sei=Matsui
en-aut-mei=Chihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=TokuyamaEijiro
en-aut-sei=Tokuyama
en-aut-mei=Eijiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=SenooTakaya
en-aut-sei=Senoo
en-aut-mei=Takaya
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=YamadaKiyoshi
en-aut-sei=Yamada
en-aut-mei=Kiyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=KamedaMasahiro
en-aut-sei=Kameda
en-aut-mei=Masahiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=TakeuchiTetsuo
en-aut-sei=Takeuchi
en-aut-mei=Tetsuo
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=KimataYoshihiro
en-aut-sei=Kimata
en-aut-mei=Yoshihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
affil-num=1
en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital
kn-affil=
affil-num=2
en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital
kn-affil=
affil-num=3
en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital
kn-affil=
affil-num=4
en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital
kn-affil=
affil-num=5
en-affil=Department of Neurological Surgery, Okayama University Hospital
kn-affil=
affil-num=6
en-affil=Department of Occlusal and Oral Functional Rehabilitation, Okayama University Hospital
kn-affil=
affil-num=7
en-affil=Department of Plastic and Reconstructive Surgery,Okayama University Hospital
kn-affil=
END
start-ver=1.4
cd-journal=joma
no-vol=71
cd-vols=
no-issue=2
article-no=
start-page=171
end-page=177
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2017
dt-pub=201704
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Three-Dimensional Imaging of Lymphatic System in Lymphedema Legs Using Interstitial Computed Tomography-lymphography
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=As a new trial, we used interstitial computed tomography-lymphography (CT-LG) in 10 patients with lower extremity lymphedema (n=20 limbs) at stage 0, 1, 2, or 3 under the International Society of Lymphology (ISL) classification. In all cases, CT-LG, lymphoscintigraphy, and indocyanine green fluorescence-lymphography (ICG-LG) were performed. In the examination of the ascending level of depicted lymphatic vessels, we measured the diameters of lymphatic vessels detected with CT-LG and conducted an image analysis of dermal backflow of lymph (DB). CT-LG had better resolution than lymphoscintigraphy and enabled the clear visualization of lymphatic vessels with a minimum lumen size of 0.7 mm. CT-LG also showed the three-dimensional architecture of the DB, which originated from deep lymphatic collectors via branched small lymphatic vessels. Our findings are quite valuable not only for detailed examinations of lymphedematous sites and for the lymphedema surgery, but also for investigations of the pathogenesis of lymphedema which has not yet been established. We observed that lymphoscintigraphy could show the lymphatic vessels up to the thigh level in all cases, whereas CT-LG enabled the vessels’ visualization up to the leg level at maximum. In conclusion, CT-LG provided adequate and detailed three-dimensional imaging of the lymphatic system in lymphedema patients.
en-copyright=
kn-copyright=
en-aut-name=YamadaKiyoshi
en-aut-sei=Yamada
en-aut-mei=Kiyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=ShinaokaAkira
en-aut-sei=Shinaoka
en-aut-mei=Akira
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=KimataYoshihiro
en-aut-sei=Kimata
en-aut-mei=Yoshihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
affil-num=1
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
kn-affil=
affil-num=2
en-affil=Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
kn-affil=
affil-num=3
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
kn-affil=
en-keyword=interstitial lymphography
kn-keyword=interstitial lymphography
en-keyword=CT lymphography
kn-keyword=CT lymphography
en-keyword=lymphedema
kn-keyword=lymphedema
en-keyword=lympatic imaging
kn-keyword=lympatic imaging
END
start-ver=1.4
cd-journal=joma
no-vol=114
cd-vols=
no-issue=8
article-no=
start-page=940
end-page=946
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2016
dt-pub=201612
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Relationship of the number and size of superficial groin lymph nodes with the stage of secondary lymphatic edema
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=PURPOSE:
This study evaluated the relationships of the size and number of superficial groin lymph nodes with the lower limb lymphedema stage and thus examined the role of superficial lymphatic lymph nodes in secondary lymphedema development.
METHODS:
We determined the number and size of superficial groin lymph nodes using horizontal plane computed tomography (CT) and the lymphedema stage in the lower limbs of 25 patients with gynecologic cancer.
RESULTS:
The patients had an average of 2.92 (range, 1-7) superficial groin lymph nodes; the mean size of the 146 evaluated lymph nodes was 7.55 mm (range, 5-15 mm). In 19 of 25 patients (76%), the side with major edema contained fewer superficial groin lymph nodes. In total, 22 patients (88%) had fewer superficial groin lymph nodes or a smaller total lymph node size on the edematous dominant side.
CONCLUSIONS:
In this evaluation of the link between superficial groin lymph node laterality and secondary lymphedema staging, we found that patients with large lymph node numbers and sizes tended to present with a relatively earlier stage of lymphedema. Our results therefore suggest that the size and number of superficial groin lymph nodes affect the lymphedema stage.
en-copyright=
kn-copyright=
en-aut-name=OnodaSatoshi
en-aut-sei=Onoda
en-aut-mei=Satoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=KimataYoshihiro
en-aut-sei=Kimata
en-aut-mei=Yoshihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=YamadaKiyoshi
en-aut-sei=Yamada
en-aut-mei=Kiyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=SekiNoriko
en-aut-sei=Seki
en-aut-mei=Noriko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=HiramatsuYuji
en-aut-sei=Hiramatsu
en-aut-mei=Yuji
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
affil-num=1
en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Science, University of Okayama
kn-affil=
affil-num=2
en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Science, University of Okayama
kn-affil=
affil-num=3
en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Science, University of Okayama
kn-affil=
affil-num=4
en-affil=Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Science, University of Okayama
kn-affil=
affil-num=5
en-affil=Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Science, University of Okayama
kn-affil=
en-keyword=gynecologic cancer
kn-keyword=gynecologic cancer
en-keyword=lower limb lymphedema
kn-keyword=lower limb lymphedema
en-keyword=risk factor
kn-keyword=risk factor
en-keyword=secondary lymphedema
kn-keyword=secondary lymphedema
en-keyword=superficial groin lymph nodes
kn-keyword=superficial groin lymph nodes
END
start-ver=1.4
cd-journal=joma
no-vol=11
cd-vols=
no-issue=12
article-no=
start-page=e8364
end-page=
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2023
dt-pub=20231221
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Nontuberculous mycobacterial abscess of lacrimal sac and eyelid debridement: Case report
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=A 56-year-old otherwise healthy woman developed abscess from dacryocystitis in the right lower eyelid. The smear of puncture fluid showed acid-fast bacilli and Mycobacterium abscessus was identified after a month. The early start of clarithromycin/ethambutol was switched to clarithromycin/levofloxacin. Debridement specimen after 7-month treatment showed granulomatous tissue with no bacilli.
en-copyright=
kn-copyright=
en-aut-name=MatsuoToshihiko
en-aut-sei=Matsuo
en-aut-mei=Toshihiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=TanakaTakehiro
en-aut-sei=Tanaka
en-aut-mei=Takehiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=YamadaKiyoshi
en-aut-sei=Yamada
en-aut-mei=Kiyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=NoseMotoko
en-aut-sei=Nose
en-aut-mei=Motoko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=TanimotoYasushi
en-aut-sei=Tanimoto
en-aut-mei=Yasushi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
affil-num=1
en-affil=Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University
kn-affil=
affil-num=2
en-affil=Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University
kn-affil=
affil-num=3
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital
kn-affil=
affil-num=4
en-affil=Department of Clinical Laboratory, Okayama University Hospital
kn-affil=
affil-num=5
en-affil=Department of Allergy and Respiratory Medicine, Okayama University Hospital
kn-affil=
en-keyword=debridement
kn-keyword=debridement
en-keyword=eyelid
kn-keyword=eyelid
en-keyword=lacrimal sac
kn-keyword=lacrimal sac
en-keyword=Mycobacterium abscessus
kn-keyword=Mycobacterium abscessus
en-keyword=nontuberculous mycobacteria
kn-keyword=nontuberculous mycobacteria
END
start-ver=1.4
cd-journal=joma
no-vol=59
cd-vols=
no-issue=16
article-no=
start-page=2067
end-page=2070
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2020
dt-pub=20200815
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Multiple Deep-seated Dentofacial Abscesses Caused by Multidrug-resistant Viridans Group Streptococci
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Odontogenic infections, generally caused by dental caries and periodontal disease, can result in fatal illness. We herein report a 71-year-old Japanese woman with type 2 diabetes and hemodialysis who suffered from multiple dentofacial abscesses mainly caused by multidrug-resistant Streptococcus oralis. She complained of pain and swelling of her face, with an extraoral fistula from the left cheek. Following 3 surgical debridement procedures and partial mandibulectomy, in addition to 12 weeks of antimicrobial therapy, the multiple dentofacial abscesses were ameliorated. A combination of surgical and antimicrobial treatments following an early diagnosis is essential for reducing further complications.
en-copyright=
kn-copyright=
en-aut-name=FukushimaShinnosuke
en-aut-sei=Fukushima
en-aut-mei=Shinnosuke
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=HagiyaHideharu
en-aut-sei=Hagiya
en-aut-mei=Hideharu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=MizutaYuki
en-aut-sei=Mizuta
en-aut-mei=Yuki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=NakanoYasuhiro
en-aut-sei=Nakano
en-aut-mei=Yasuhiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
en-aut-name=TakaharaMasahiro
en-aut-sei=Takahara
en-aut-mei=Masahiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=
en-aut-name=OkamotoKayo
en-aut-sei=Okamoto
en-aut-mei=Kayo
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=
en-aut-name=HayashiYuko
en-aut-sei=Hayashi
en-aut-mei=Yuko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=
en-aut-name=YamadaKiyoshi
en-aut-sei=Yamada
en-aut-mei=Kiyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=8
ORCID=
en-aut-name=HasegawaKou
en-aut-sei=Hasegawa
en-aut-mei=Kou
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=9
ORCID=
en-aut-name=OtsukaFumio
en-aut-sei=Otsuka
en-aut-mei=Fumio
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=10
ORCID=
affil-num=1
en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=2
en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=3
en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=4
en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=5
en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=6
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=7
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=8
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=9
en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
affil-num=10
en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
kn-affil=
en-keyword=dentofacial abscesses
kn-keyword=dentofacial abscesses
en-keyword=odontogenic infection
kn-keyword=odontogenic infection
en-keyword=osteomyelitis
kn-keyword=osteomyelitis
en-keyword=multidrug resistance
kn-keyword=multidrug resistance
en-keyword=viridans
kn-keyword=viridans
en-keyword=Streptococcus
kn-keyword=Streptococcus
END
start-ver=1.4
cd-journal=joma
no-vol=137
cd-vols=
no-issue=1
article-no=
start-page=83e
end-page=91e
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2016
dt-pub=201601
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Histologic Evaluation of Lymphaticovenular Anastomosis Outcomes in the Rat Experimental Model: Comparison of Cases with Patency and Obstruction
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=BACKGROUND:
Lymphaticovenular anastomosis plays an important role in the surgical treatment of lymphedema. The outcomes of lymphaticovenular anastomosis are evaluated based on changes in edema; however, isolated assessment of the anastomosis itself is difficult. The authors used an animal experimental model to conduct a detailed examination of histologic changes associated with lymphaticovenular anastomosis and determined the factors important for success.
METHODS:
The experimental lymphaticovenular anastomosis model was created using lumbar lymph ducts and iliolumbar veins of Wistar rats. The authors performed anastomosis under a microscope and reviewed postoperative histologic changes using optical and electron microscopy. In addition, electron microscopy and histology were used for detailed examination of the area in the vicinity of the anastomotic region in cases with patency and obstruction.
RESULTS:
The patency rates immediately after, 1 week after, and 1 month after lymphaticovenular anastomosis were 100 percent (20 of 20), 70 percent (14 of 20), and 65 percent, respectively. A detailed examination of the anastomotic region with electron microscopy revealed that, in cases with patency, there was no notable transformation of the endothelial cells, which formed a smooth layer. In contrast, in obstruction cases, the corresponding region of the endothelium was irregular in structure.
CONCLUSIONS:
Vessel obstruction after lymphaticovenular anastomosis may be associated with irregular arrangement of the endothelial layer, leading to exposure of subendothelial tissues and platelet formation. One part of the postoperative changes after anastomosis and a cause of obstruction were elucidated in this study. The authors' results may enable improvements in lymphaticovenular anastomosis by translating back to real clinical operations.
en-copyright=
kn-copyright=
en-aut-name=OnodaSatoshi
en-aut-sei=Onoda
en-aut-mei=Satoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=KimataYoshihiro
en-aut-sei=Kimata
en-aut-mei=Yoshihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=MatsumotoKumiko
en-aut-sei=Matsumoto
en-aut-mei=Kumiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=YamadaKiyoshi
en-aut-sei=Yamada
en-aut-mei=Kiyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
affil-num=1
en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, University of Okayama
kn-affil=
affil-num=2
en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, University of Okayama
kn-affil=
affil-num=3
en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, University of Okayama
kn-affil=
affil-num=4
en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, University of Okayama
kn-affil=
END
start-ver=1.4
cd-journal=joma
no-vol=12
cd-vols=
no-issue=1
article-no=
start-page=309
end-page=
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2022
dt-pub=20220110
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=A new severity classification of lower limb secondary lymphedema based on lymphatic pathway defects in an indocyanine green fluorescent lymphography study
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Most protocols for lymphatic imaging of the lower limb conventionally inject tracer materials only into the interdigital space; however, recent studies indicate that there are four independent lymphatic vessel groups (anteromedial, anterolateral, posteromedial, and posterolateral) in the lower limb. Thus, three additional injection sites are needed for lymphatic imaging of the entire lower limb. We aimed to validate a multiple injection designed protocol and demonstrate its clinical benefits. Overall, 206 lower limbs undergoing indocyanine green fluorescent lymphography with the new injection protocol were registered retrospectively. To assess the influence of predictor variables on the degree of severity, multivariable logistic regression models were used with individual known risk factors. Using a generalized linear model, the area under the curve (AUC) of the conventional clinical model, comprising known severity risk factors, was compared with that of the modified model that included defects in the posterolateral and posteromedial groups. Multivariable logistic regression models showed a significant difference for the posteromedial and posterolateral groups. The AUC of the modified model was significantly improved compared to that of the conventional clinical model. Finding defects in the posteromedial and posterolateral groups is a significant criterion for judging lymphedema severity and introducing a new lymphedema severity classification.
en-copyright=
kn-copyright=
en-aut-name=ShinaokaAkira
en-aut-sei=Shinaoka
en-aut-mei=Akira
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=
en-aut-name=KamiyamaKazuyo
en-aut-sei=Kamiyama
en-aut-mei=Kazuyo
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=
en-aut-name=YamadaKiyoshi
en-aut-sei=Yamada
en-aut-mei=Kiyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=
en-aut-name=KimataYoshihiro
en-aut-sei=Kimata
en-aut-mei=Yoshihiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=
affil-num=1
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
kn-affil=
affil-num=2
en-affil=Department of Nursing, Kagawa Prefectural Central Hospital
kn-affil=
affil-num=3
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
kn-affil=
affil-num=4
en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
kn-affil=
END