start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=5 article-no= start-page=e8933 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202405 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Decades of stability of conjunctival vascular malformations in two patients en-subtitle= kn-subtitle= en-abstract= kn-abstract=A 65-year-old woman with diabetic retinopathy underwent glaucoma surgery to construct a filtering bleb adjacent to conjunctival hemangioma, and showed bleb function and stable hemangioma for a decade. A 1.5-year-old girl with right eye lid and cheek swelling by orbital to facial lymphangioma was followed for visual acuity development. Conjunctival lymphangioma was stable in 20 years. 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=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=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, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=hemangioma kn-keyword=hemangioma en-keyword=lymphangioma kn-keyword=lymphangioma en-keyword=lymphatic malformation kn-keyword=lymphatic malformation en-keyword=pathology kn-keyword=pathology en-keyword=trabeculectomy kn-keyword=trabeculectomy en-keyword=vascular malformation kn-keyword=vascular malformation END start-ver=1.4 cd-journal=joma no-vol=135 cd-vols= no-issue=3 article-no= start-page=152 end-page=157 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20231201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A 4th step of visual art instruction in medical education kn-title=医学における「ビジュアルアート教育」の展開：第４ステップ― 医学教育に必要な“気づき”を与える授業― en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=1 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name=小比賀美香子 kn-aut-sei=小比賀 kn-aut-mei=美香子 aut-affil-num=2 ORCID= en-aut-name=KuboTakuya en-aut-sei=Kubo en-aut-mei=Takuya kn-aut-name=久保卓也 kn-aut-sei=久保 kn-aut-mei=卓也 aut-affil-num=3 ORCID= en-aut-name=OtsukaMasumi en-aut-sei=Otsuka en-aut-mei=Masumi kn-aut-name=大塚益美 kn-aut-sei=大塚 kn-aut-mei=益美 aut-affil-num=4 ORCID= en-aut-name=OkamotoYuko en-aut-sei=Okamoto en-aut-mei=Yuko kn-aut-name=岡本裕子 kn-aut-sei=岡本 kn-aut-mei=裕子 aut-affil-num=5 ORCID= en-aut-name=FukutomiKoh en-aut-sei=Fukutomi en-aut-mei=Koh kn-aut-name=福冨幸 kn-aut-sei=福冨 kn-aut-mei=幸 aut-affil-num=6 ORCID= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi kn-aut-name=松本洋 kn-aut-sei=松本 kn-aut-mei=洋 aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil=岡山大学病院　形成再建外科 affil-num=2 en-affil=Department of General Medicine, Okayama University Hospital kn-affil=岡山大学病院　総合内科・総合診療科 affil-num=3 en-affil=Department of Emergency and Critical Care Medicine, Okayama University Hospital kn-affil=岡山大学病院　救命救急科 affil-num=4 en-affil=OTSUKA DESIGN Co., Ltd. kn-affil=株式会社大塚デザイン affil-num=5 en-affil=Okayama Prefectural Museum of Art kn-affil=岡山県立美術館 affil-num=6 en-affil=Okayama Prefectural Museum of Art kn-affil=岡山県立美術館 affil-num=7 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil=岡山大学病院　形成再建外科 END start-ver=1.4 cd-journal=joma no-vol=135 cd-vols= no-issue=3 article-no= start-page=129 end-page=135 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20231201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Development of head and neck reconstruction and procedures learned from patients kn-title=患者が教えてくれた頭頸部再建と手技の開発 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=1 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil=岡山大学学術研究院医歯薬学域　形成再建外科学 en-keyword=頭頸部 kn-keyword=頭頸部 en-keyword=再建 kn-keyword=再建 en-keyword=合併症 kn-keyword=合併症 en-keyword=分類 kn-keyword=分類 END start-ver=1.4 cd-journal=joma no-vol=135 cd-vols= no-issue=2 article-no= start-page=85 end-page=88 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230801 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A third step of visual art instruction in medical education : Introduction of visual thinking strategies supported by Okayama Prefectural Museum of Art kn-title=医学における「ビジュアルアート教育」の展開：第３ステップ― 岡山県立美術館の協力による対話型鑑賞の導入― en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=1 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name=小比賀美香子 kn-aut-sei=小比賀 kn-aut-mei=美香子 aut-affil-num=2 ORCID= en-aut-name=KuboTakuya en-aut-sei=Kubo en-aut-mei=Takuya kn-aut-name=久保卓也 kn-aut-sei=久保 kn-aut-mei=卓也 aut-affil-num=3 ORCID= en-aut-name=OtsukaMasumi en-aut-sei=Otsuka en-aut-mei=Masumi kn-aut-name=大塚益美 kn-aut-sei=大塚 kn-aut-mei=益美 aut-affil-num=4 ORCID= en-aut-name=OkamotoYuko en-aut-sei=Okamoto en-aut-mei=Yuko kn-aut-name=岡本裕子 kn-aut-sei=岡本 kn-aut-mei=裕子 aut-affil-num=5 ORCID= en-aut-name=FukutomiKoh en-aut-sei=Fukutomi en-aut-mei=Koh kn-aut-name=福冨幸 kn-aut-sei=福冨 kn-aut-mei=幸 aut-affil-num=6 ORCID= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi kn-aut-name=松本洋 kn-aut-sei=松本 kn-aut-mei=洋 aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil=岡山大学病院　形成再建外科 affil-num=2 en-affil=Department of General Medicine, Okayama University Hospital kn-affil=岡山大学病院　総合内科・総合診療科 affil-num=3 en-affil=Department of Emergency and Critical Care Medicine, Okayama University Hospital kn-affil=岡山大学病院　救命救急科 affil-num=4 en-affil=OTSUKA DESIGN Co., Ltd. kn-affil=株式会社大塚デザイン affil-num=5 en-affil=Okayama Prefectural Museum of Art kn-affil=岡山県立美術館 affil-num=6 en-affil=Okayama Prefectural Museum of Art kn-affil=岡山県立美術館 affil-num=7 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil=岡山大学病院　形成再建外科 END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=1 article-no= start-page=11 end-page=19 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202302 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Safety and Efficacy of a Well-Fitting Brassiere after Breast Reconstruction: A Qualitative Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=The importance of a well-fitted, comfortable brassiere to overall quality of life after breast reconstruction has not been evaluated. Our aim was to determine the impact of a semi-customized brassiere on patients’ health-related quality of life after breast reconstruction. The subjects were prospective patients with mastectomy who were to undergo immediate or delayed breast reconstruction at our hospital. After surgery, a professional bra fitter sized each patient for a semi-customized brassiere and provided follow-up consultations. A self-reported questionnaire on breast aesthetics, postoperative pain, and satisfaction was used to assess the primary outcomes. Data were prospectively collected at baseline (before surgery) and at 1, 3, 6, and 12 months after surgery and analyzed. Forty-six patients (50 breasts) were included in the analysis. Consistent wearing of the brassiere reduced pain (p<0.05), with good overall satisfaction (p<0.001). Aesthetic scores on breast shape and size were higher with than without the custom brassiere at 3 months (p=0.02) and 6 months (p=0.03) after surgery. Wearing the brassiere reduced anxiety at all time points of measurement. A well-fitting brassiere ensured safety and provided a high degree of satisfaction without anxiety for patients after breast reconstruction. en-copyright= kn-copyright= en-aut-name=WatanabeSatoko en-aut-sei=Watanabe en-aut-mei=Satoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SaigaMiho en-aut-sei=Saiga en-aut-mei=Miho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MotokiTakayuki en-aut-sei=Motoki en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ShienTadahiko en-aut-sei=Shien en-aut-mei=Tadahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TairaNaruto en-aut-sei=Taira en-aut-mei=Naruto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=DoiharaHiroyoshi en-aut-sei=Doihara en-aut-mei=Hiroyoshi 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 General Surgery, Okayama Saiseikai General Hospital kn-affil= affil-num=4 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= en-keyword=breast reconstruction kn-keyword=breast reconstruction en-keyword=mastectomy kn-keyword=mastectomy en-keyword=brassiere kn-keyword=brassiere en-keyword=professional bra fitter kn-keyword=professional bra fitter END start-ver=1.4 cd-journal=joma no-vol=133 cd-vols= no-issue=3 article-no= start-page=198 end-page=199 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20211201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The 45th Annual Meeting of the Japanese Society of Lymphology kn-title=第45回日本リンパ学会総会 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=1 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学学術研究院医歯薬学域　形成再建外科学 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 start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=2 article-no= start-page=243 end-page=248 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202104 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Pyogenic Ventriculitis After Anterior Skull Base Surgery Treated With Endoscopic Ventricular Irrigation And Reconstruction Using a Vascularized Flap en-subtitle= kn-subtitle= en-abstract= kn-abstract=Ventriculitis is a rare, serious complication of neurosurgery. A 59-year-old man who had undergone a craniotomy for a paranasal adenocarcinoma, developed a right frontal cystic lesion. We performed a bifrontal craniotomy to remove the lesion. The dura was repaired with non-vascularized free fascia lata in watertight fashion. Ventriculitis occurred 3 days postoperatively. Ventricular drainage, craniectomy, and endoscopic irrigation were undertaken to remove an abscess. The dura and the resection cavity were reconstructed using a vascularized anterolateral thigh adipofascial flap. His symptoms disappeared, indicating that endoscopic irrigation and reconstruction can effectively address ventriculitis even in patients in critical clinical condition. en-copyright= kn-copyright= en-aut-name=TomitaYusuke en-aut-sei=Tomita en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShimazuYosuke en-aut-sei=Shimazu en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KawakamiMasato en-aut-sei=Kawakami en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FujiiKentaro en-aut-sei=Fujii en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 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=6 ORCID= en-aut-name=YasuharaTakao en-aut-sei=Yasuhara en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SurugaYasuki en-aut-sei=Suruga en-aut-mei=Yasuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OtaTomoyuki en-aut-sei=Ota en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 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=10 ORCID= en-aut-name=KurozumiKazuhiko en-aut-sei=Kurozumi en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=DateIsao en-aut-sei=Date en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=ventriculitis kn-keyword=ventriculitis en-keyword=surgical site infection kn-keyword=surgical site infection en-keyword=intraventricular antimicrobial therapy kn-keyword=intraventricular antimicrobial therapy en-keyword=anterior skull base surgery kn-keyword=anterior skull base surgery END start-ver=1.4 cd-journal=joma no-vol=11 cd-vols= no-issue=2 article-no= start-page=e042099 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=2021 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Protocol for a multicentre, prospective, cohort study to investigate patient satisfaction and quality of life after immediate breast reconstruction in Japan: the SAQLA study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction The aim of breast reconstruction (BR) is to improve patients' health-related quality of life (HRQOL). Therefore, measuring patient-reported outcomes (PROs) would clarify the value and impact of BR on a patient's life and thus would provide evidence-based information to help decision-making. The Satisfaction and Quality of Life After Immediate Breast Reconstruction study aimed to investigate satisfaction and HRQOL in Japanese patients with breast cancer who undergo immediate breast reconstruction (IBR). Methods and analysis This ongoing prospective, observational multicentre study will assess 406 patients who had unilateral breast cancer and underwent mastectomy and IBR, and were recruited from April 2018 to July 2019. All participants were recruited from seven hospitals: Okayama University Hospital, Iwate Medical University Hospital, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Showa University Hospital, University of Tsukuba Hospital, Osaka University Hospital and Yokohama City University Medical Center. The patients will be followed up for 36 months postoperatively. The primary endpoint of this study will be the time-dependent changes in BREAST-Q satisfaction with breast subscale scores for 12 months after reconstructive surgery, which will be collected via an electronic PRO system. Ethics and dissemination This study will be performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan's Ministry of Education, Science and Technology and the Ministry of Health, Labour and Welfare, the modified Act on the Protection of Personal Information and the Declaration of Helsinki. This study protocol was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, on 2 February 2018 (1801-039) and all other participating sites. The findings of this trial will be submitted to an international peer-reviewed journal. en-copyright= kn-copyright= en-aut-name=SaigaMiho en-aut-sei=Saiga en-aut-mei=Miho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HosoyaYuko en-aut-sei=Hosoya en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=UtsunomiyaHiroki en-aut-sei=Utsunomiya en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KuramotoYukiko en-aut-sei=Kuramoto en-aut-mei=Yukiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WatanabeSatoko en-aut-sei=Watanabe en-aut-mei=Satoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TomitaKoichi en-aut-sei=Tomita en-aut-mei=Koichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=AiharaYukiko en-aut-sei=Aihara en-aut-mei=Yukiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MutoMayu en-aut-sei=Muto en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HikosakaMakoto en-aut-sei=Hikosaka en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KawaguchiTakashi en-aut-sei=Kawaguchi en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MiyajiTempei en-aut-sei=Miyaji en-aut-mei=Tempei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=YamaguchiTakuhiro en-aut-sei=Yamaguchi en-aut-mei=Takuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=ZendaSadamoto en-aut-sei=Zenda en-aut-mei=Sadamoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=GotoAya en-aut-sei=Goto en-aut-mei=Aya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SakurabaMinoru en-aut-sei=Sakuraba en-aut-mei=Minoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=KusanoTaro en-aut-sei=Kusano en-aut-mei=Taro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=MiyabeKenta en-aut-sei=Miyabe en-aut-mei=Kenta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=KurokiTomoaki en-aut-sei=Kuroki en-aut-mei=Tomoaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=YanoTomoyuki en-aut-sei=Yano en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=TaminatoMifue en-aut-sei=Taminato en-aut-mei=Mifue kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=SekidoMitsuru en-aut-sei=Sekido en-aut-mei=Mitsuru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=TsunodaYui en-aut-sei=Tsunoda en-aut-mei=Yui kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=SatakeToshihiko en-aut-sei=Satake en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=DoiharaHiroyoshi en-aut-sei=Doihara en-aut-mei=Hiroyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 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=25 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, Iwate Medical University kn-affil= affil-num=3 en-affil=Department of Surgery and Plastic Surgery, Showa University Koto Toyosu Hospital kn-affil= affil-num=4 en-affil=Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research kn-affil= affil-num=5 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University kn-affil= affil-num=7 en-affil=Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba kn-affil= affil-num=8 en-affil=Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center kn-affil= affil-num=9 en-affil=Department of Plastic and Reconstructive Surgery, National Center for Child Health and Development kn-affil= affil-num=10 en-affil=Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences kn-affil= affil-num=11 en-affil=Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo kn-affil= affil-num=12 en-affil=Division of Biostatistics, Tohoku University Graduate School of Medicine kn-affil= affil-num=13 en-affil=Division of Radiation Oncology, National Cancer Center Hospital East kn-affil= affil-num=14 en-affil=Department of Plastic and Reconstructive Surgery, Iwate Medical University kn-affil= affil-num=15 en-affil=Department of Plastic and Reconstructive Surgery, Iwate Medical University kn-affil= affil-num=16 en-affil=Kusano Taro Clinic kn-affil= affil-num=17 en-affil=Department of Plastic and Reconstructive Surgery, Showa University Hospital kn-affil= affil-num=18 en-affil=Department of Plastic and Reconstructive Surgery, Showa University Hospital kn-affil= affil-num=19 en-affil=Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research kn-affil= affil-num=20 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University kn-affil= affil-num=21 en-affil=Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba kn-affil= affil-num=22 en-affil=Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center kn-affil= affil-num=23 en-affil=Department of Plastic and Reconstructive Surgery, Toyama University Hospital kn-affil= affil-num=24 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=25 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= en-keyword=plastic & reconstructive surgery kn-keyword=plastic & reconstructive surgery en-keyword=breast surgery kn-keyword=breast surgery en-keyword=breast tumours kn-keyword=breast tumours END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=23 article-no= start-page=5374 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20201126 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Long-Term Effect of Honeycomb beta-Tricalcium Phosphate on Zygomatic Bone Regeneration in Rats en-subtitle= kn-subtitle= en-abstract= kn-abstract=In recent years, artificial bones with high biocompatibility have been developed for hard tissue reconstruction. However, current bone replacement methods are inadequate for large defects, causing infection, exposure, and damage. We have developed a new honeycomb beta-tricalcium phosphate (TCP) material, which achieved good bone regeneration after implantation in a rat complete zygomatic bone defect. In this study, we further investigated the ability of honeycomb beta- TCP for remodeling after bone regeneration as a long-term result. Bone morphogenic protein (BMP)-2-free honeycomb beta-TCP (TCP group) and honeycomb beta-TCP with BMP-2 (BMP group) were implanted in the zygomatic bone of rats. Micro-computed tomography was performed to track the zygomatic bone morphology, and specimens were histologically examined for osteogenesis and remodeling. In the TCP group, no bone formation was observed at 1 month, but it was observed at 6 months. Bone formation was observed in the BMP group at 1 month, and beta-TCP absorption reproducing the zygomatic bone morphology was observed at 6 months. This honeycomb beta-TCP with BMP-2 may provide appropriate remodeling that reproduces good bone formation in the early stage and good morphology in the long term, offering an alternative bone reconstruction material to vascularized bone grafts. en-copyright= kn-copyright= en-aut-name=NakagiriRyoko en-aut-sei=Nakagiri en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeSatoko en-aut-sei=Watanabe en-aut-mei=Satoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakabatakeKiyofumi en-aut-sei=Takabatake en-aut-mei=Kiyofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TsujigiwaHidetsugu en-aut-sei=Tsujigiwa en-aut-mei=Hidetsugu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi 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, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Life Science, Faculty of Science, University Science kn-affil= affil-num=5 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=bioceramic kn-keyword=bioceramic en-keyword=bone tissue regeneration kn-keyword=bone tissue regeneration en-keyword=honeycomb beta-TCP kn-keyword=honeycomb beta-TCP en-keyword=bone remodeling kn-keyword=bone remodeling en-keyword=reproduction of morphology kn-keyword=reproduction of morphology END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue= article-no= start-page=100595 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202009 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=HAMAMATSU-ICG study: Protocol for a phase III, multicentre, single-arm study to assess the usefulness of indocyanine green fluorescent lymphography in assessing secondary lymphoedema en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction
Secondary lymphoedema of the extremities is an important quality-of-life issue for patients who were treated for their malignancies. Indocyanine green (ICG) fluorescent lymphography may be helpful for assessing lymphoedema and for planning lymphaticovenular anastomosis (LVA). The objective of the present clinical trial is to confirm whether or not ICG fluorescent lymphography using the near-infrared monitoring camera is useful for assessing the indication for LVA, for the identification of the lymphatic vessels before the conduct of LVA, and for the confirmation of the patency of the anastomosis site during surgery.
Methods and analysis
This trial is a phase III, multicentre, single-arm, open-label clinical trial to assess the efficacy and safety of ICG fluorescent lymphography when assessing and treating lymphoedema of patients with secondary lymphoedema who are under consideration for LVA. The primary endpoint is the identification rate of the lymphatic vessels at the incision site based on ICG fluorescent lymphograms obtained before surgery. The secondary endpoints are 1) the sensitivity and specificity of dermal back flow determined by ICG fluorescent lymphography as compared with 99mTc lymphoscintigraphy—one of the standard diagnostic methods and 2) the usefulness of ICG fluorescent lymphography when confirming the patency of the anastomosis site after LVA.
Ethics and dissemination
The protocol for the study was approved by the Institutional Review Board of each institution. The trial was filed for and registered at the Pharmaceuticals and Medical Devices Agency in Japan. The trial is currently on-going and is scheduled to end in June 2020. en-copyright= kn-copyright= en-aut-name=AkitaShinsuke en-aut-sei=Akita en-aut-mei=Shinsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UnnoNaoki en-aut-sei=Unno en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MaegawaJiro en-aut-sei=Maegawa en-aut-mei=Jiro 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= en-aut-name=FukamizuHidekazu en-aut-sei=Fukamizu en-aut-mei=Hidekazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YabukiYuichiro en-aut-sei=Yabuki en-aut-mei=Yuichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 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=7 ORCID= en-aut-name=SanoMasaki en-aut-sei=Sano en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KawasakiYohei en-aut-sei=Kawasaki en-aut-mei=Yohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=FujiwaraTadami en-aut-sei=Fujiwara en-aut-mei=Tadami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HanaokaHideki en-aut-sei=Hanaoka en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MitsukawaNobuyuki en-aut-sei=Mitsukawa en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Vascular Surgery, Hamamatsu Medical Center kn-affil= affil-num=3 en-affil=Department of Plastic and Reconstructive Surgery, Yokohama City University, Graduate School of Medicin 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= affil-num=5 en-affil=Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine kn-affil= affil-num=6 en-affil=Department of Plastic and Reconstructive Surgery, Yokohama City University, Graduate School of Medicine kn-affil= affil-num=7 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science kn-affil= affil-num=8 en-affil=Second Department of Surgery, Hamamatsu University School of Medicine kn-affil= affil-num=9 en-affil=Clinical Research Center, Chiba University Hospital kn-affil= affil-num=10 en-affil=Clinical Research Center, Chiba University Hospital kn-affil= affil-num=11 en-affil=Clinical Research Center, Chiba University Hospital kn-affil= affil-num=12 en-affil=Department of Plastic, Reconstructive, and Aesthetic Surgery, Chiba University Graduate School of Medicine kn-affil= en-keyword=Indocyanine green fluorescent lymphography kn-keyword=Indocyanine green fluorescent lymphography en-keyword=Secondary lymphoedema kn-keyword=Secondary lymphoedema en-keyword=Lymphaticovenular anastomosis kn-keyword=Lymphaticovenular anastomosis END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=21 article-no= start-page=4761 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20201025 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effect of Honeycomb β-TCP Geometrical Structure on Bone Tissue Regeneration in Skull Defect en-subtitle= kn-subtitle= en-abstract= kn-abstract=The effect of the geometric structure of artificial biomaterials on skull regeneration remains unclear. In a previous study, we succeeded in developing honeycomb beta-tricalcium phosphate (beta-TCP), which has through-and-through holes and is able to provide the optimum bone microenvironment for bone tissue regeneration. We demonstrated that beta-TCP with 300-mu m hole diameters induced vigorous bone formation. In the present study, we investigated how differences in hole directions of honeycomb beta-TCP (horizontal or vertical holes) influence bone tissue regeneration in skull defects. Honeycomb beta-TCP with vertical and horizontal holes was loaded with BMP-2 using Matrigel and Collagen gel as carriers, and transplanted into skull bone defect model rats. The results showed that in each four groups (Collagen alone group, Matrigel alone group, Collagen + BMP group and Matrigel + BMP-2), vigorous bone formation was observed on the vertical beta-TCP compared with horizontal beta-TCP. The osteogenic area was larger in the Matrigel groups (with and without BMP-2) than in the Collagen group (with and without BMP-2) in both vertical beta-TCP and horizontal beta-TCP. However, when BMP-2 was added, the bone formation area was not significantly different between the Collagen group and the Matrigel group in the vertical beta-TCP. Histological finding showed that, in vertical honeycomb beta-TCP, new bone formation extended to the upper part of the holes and was observed from the dura side to the periosteum side as added to the inner walls of the holes. Therefore, we can control efficient bone formation by creating a bone microenvironment provided by vertical honeycomb beta-TCP. Vertical honeycomb beta-TCP has the potential to be an excellent biomaterial for bone tissue regeneration in skull defects and is expected to have clinical applications. en-copyright= kn-copyright= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakabatakeKiyofumi en-aut-sei=Takabatake en-aut-mei=Kiyofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TsujigiwaHidetsugu en-aut-sei=Tsujigiwa en-aut-mei=Hidetsugu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeSatoko en-aut-sei=Watanabe en-aut-mei=Satoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakagiriRyoko en-aut-sei=Nakagiri en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NakanoKeisuke en-aut-sei=Nakano en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NagatsukaHitoshi en-aut-sei=Nagatsuka en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 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=8 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Life Science, Faculty of Science, Okayama University Science kn-affil= affil-num=4 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword= honeycomb β-TCP kn-keyword= honeycomb β-TCP en-keyword=bone tissue regeneration kn-keyword=bone tissue regeneration en-keyword=bone microenvironment kn-keyword=bone microenvironment en-keyword=Vertical and Horizontal holes kn-keyword=Vertical and Horizontal holes en-keyword=geometrical structure kn-keyword=geometrical structure END start-ver=1.4 cd-journal=joma no-vol=132 cd-vols= no-issue=2 article-no= start-page=98 end-page=101 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200803 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A second step of visual art instruction in medical education : Development of observational and communication skills kn-title=医学における「ビジュアルアート教育」の導入：第2 ステップ― アートから診る力，伝える力を養う― en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi kn-aut-name=松本洋 kn-aut-sei=松本 kn-aut-mei=洋 aut-affil-num=1 ORCID= en-aut-name=KitaguchiYohei en-aut-sei=Kitaguchi en-aut-mei=Yohei kn-aut-name=北口陽平 kn-aut-sei=北口 kn-aut-mei=陽平 aut-affil-num=2 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=3 ORCID= en-aut-name=OtsukaMasumi en-aut-sei=Otsuka en-aut-mei=Masumi kn-aut-name=大塚益美 kn-aut-sei=大塚 kn-aut-mei=益美 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 Sciences kn-affil=岡山大学大学院医歯薬学総合研究科　形成再建外科学 affil-num=2 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学大学院医歯薬学総合研究科　形成再建外科学 affil-num=3 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学大学院医歯薬学総合研究科　形成再建外科学 affil-num=4 en-affil=OTSUKA DESIGN Co., Ltd. kn-affil=株式会社大塚デザイン 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=74 cd-vols= no-issue=1 article-no= start-page=83 end-page=87 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Novel Eryngii Method of Nipple Reduction for Female-to-Male Transsexuals en-subtitle= kn-subtitle= en-abstract= kn-abstract= Nosaka, NobuyukiMastectomy is usually the first and most important surgical procedure in female-to-male (FTM) individuals with gender identity disorder. Nipple reduction is also important in the process of reconstructing the chest wall for a more male appearance. If the nipples remain large after a mastectomy, the results may be disappointing to many FTM transsexuals. Nipple reduction enables these individuals to go to the beach or Japanese public baths, where they may go topless in public. We therefore consider that nipple reduction is indicated for all FTM transsexuals who desire it. There are a variety of methods for the reduction of enlarged nipples for women or non-FTM patients, but only a few reports have described the process used to create masculine-appearing nipples for FTM transsexuals. We developed a novel technique called the Eryngii method for creating male-like nipples using a 4-mm diameter dermal punch knife. The name of the method refers to the Eryngii king trumpet mushroom, which the nipple resembles after the surgical process. The main strength of this method is that it permits the creation of ideal nipples without difficulty. Here we introduce the technique and discuss our history of surgical methods for nipple reduction, including improvements and elaborations. en-copyright= kn-copyright= en-aut-name=SakuraiToru en-aut-sei=Sakurai en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ManakoKensuke en-aut-sei=Manako en-aut-mei=Kensuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KomagoeSyo en-aut-sei=Komagoe en-aut-mei=Syo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MukaiYuko en-aut-sei=Mukai en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KimataYoshiro en-aut-sei=Kimata en-aut-mei=Yoshiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo 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 Surgery, Okayama Saiseikai General Hospital kn-affil= affil-num=5 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Gender Center, Okayama University Hospital kn-affil= en-keyword=nipple reconstruction kn-keyword=nipple reconstruction en-keyword=female-to-male kn-keyword=female-to-male en-keyword=transmen kn-keyword=transmen en-keyword=mastectomy kn-keyword=mastectomy en-keyword=top surgery kn-keyword=top surgery END start-ver=1.4 cd-journal=joma no-vol=33 cd-vols= no-issue=1 article-no= start-page=183 end-page=189 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201901 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Relationship Between Renal Dysfunction and Oral Mucositis in Patients Undergoing Concurrent Chemoradiotherapy for Pharyngeal Cancer: A Retrospective Cohort Study. en-subtitle= kn-subtitle= en-abstract= kn-abstract=BACKGROUND/AIM:
The aim of this retrospective cohort study was to investigate the association between renal dysfunction (RD) and the development of oral mucositis (OM) in patients undergoing concurrent chemoradiotherapy (CCRT) for pharyngeal cancer including radiation to the oral cavity.
PATIENTS AND METHODS:
Of 130 patients diagnosed as having pharyngeal cancer who received CCRT at the Okayama University Hospital Head and Neck Cancer Center, 44 were finally selected.
RESULTS:
During the observation period, 24 (54.5%) patients experienced severe OM (grade 3). The Cox proportional hazards regression model demonstrated that RD (hazard ratio(HR)=2.45, 95% confidence interval(CI)=1.067-6.116, p=0.035) and nasopharynx/oropharynx as center of the irradiated area (HR=2.56, 95% CI=1.072-5.604, p=0.034) were significantly associated with the incidence of severe OM (grade 3).
CONCLUSION:
In patients with pharyngeal cancer treated with CCRT including radiation to the oral cavity, RD at baseline can be a risk factor for developing severe OM. en-copyright= kn-copyright= en-aut-name=MIZUNOHIROFUMI en-aut-sei=MIZUNO en-aut-mei=HIROFUMI kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MIYAIHISATAKA en-aut-sei=MIYAI en-aut-mei=HISATAKA kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YOKOIAYA en-aut-sei=YOKOI en-aut-mei=AYA kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KOBAYASHITERUMASA en-aut-sei=KOBAYASHI en-aut-mei=TERUMASA kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=INABUCHIAKI en-aut-sei=INABU en-aut-mei=CHIAKI kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MARUYAMATAKAYUKI en-aut-sei=MARUYAMA en-aut-mei=TAKAYUKI kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=EKUNIDAISUKE en-aut-sei=EKUNI en-aut-mei=DAISUKE kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MIZUKAWANOBUYOSHI en-aut-sei=MIZUKAWA en-aut-mei=NOBUYOSHI kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KARIYASHIN en-aut-sei=KARIYA en-aut-mei=SHIN kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NISHIZAKIKAZUNORI en-aut-sei=NISHIZAKI en-aut-mei=KAZUNORI kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 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=11 ORCID= en-aut-name=MORITAMANABU en-aut-sei=MORITA en-aut-mei=MANABU kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Junpukai Daiku Dental Clinic kn-affil= affil-num=6 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=9 en-affil=Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Head and neck cancer kn-keyword=Head and neck cancer en-keyword=concurrent chemoradiotherapy kn-keyword=concurrent chemoradiotherapy en-keyword=creatinine clearance kn-keyword=creatinine clearance en-keyword=oral mucositis kn-keyword=oral mucositis en-keyword=renal dysfunction kn-keyword=renal dysfunction END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=5 article-no= start-page=441 end-page=447 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201910 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Risk Factors for Postoperative Hematoma after Chest Wall Contouring for Female-to-Male Transsexuals: A Clinical Study en-subtitle= kn-subtitle= en-abstract= kn-abstract= Gender dysphoria is a condition in which a discrepancy between biological sex and gender identity causes distress. Many female-to-male transsexuals (FTMTS) are uncomfortable with female breasts. Chest wall contouring surgery is effective for obtaining a male-type chest, reducing mental stress, and increasing sexual satisfaction in such cases. At the Okayama University Hospital Gender Center, we have obtained positive results using an algorithm to determine the most appropriate surgical method for chest wall contouring in FTMTS patients. However, serious complications requiring reoperation, such as hematoma, may still occur. Postoperative hematomas were found in 15 (4.18%) of 358 FTMTS patients who underwent chest contouring surgery at our hospital between 2006 and 2018. Postoperative hematoma was examined retrospectively. The median time to the onset of hematoma was 7 (6-12) h after the initial surgery. The main blood vessels causing bleeding were those in the head-side skin flap region where visual confirmation was difficult and the perforator vessels from the pectoralis major muscle. Intraoperative bleeding and the operation time had a significant impact on the onset of postoperative hematoma. This is the first retrospective study that investigated the blood vessels and other factors contributing to postoperative hematoma development after chest wall contouring. en-copyright= kn-copyright= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SakuraiToru en-aut-sei=Sakurai en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MukaiYuko en-aut-sei=Mukai en-aut-mei=Yuko 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= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo 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,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 Gender Center, Okayama University Hospital kn-affil= en-keyword=female-to-male transsexuals kn-keyword=female-to-male transsexuals en-keyword=chest wall contouring kn-keyword=chest wall contouring en-keyword=postoperative hematoma kn-keyword=postoperative hematoma END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=5 article-no= start-page=393 end-page=401 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201910 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Developing Microsurgery through Experience in Yangon General Hospital, Myanmar en-subtitle= kn-subtitle= en-abstract= kn-abstract= Although many surgical centers perform microsurgery routinely in developed countries, performing microsurgery is challenging in resource-poor developing countries, such as Myanmar. With the establishment of educational training programs and the assistance of volunteer plastic surgical teams, local plastic surgeons can learn the techniques of microsurgery and apply them clinically. The purpose of this study was to establish baseline data and define the challenges of performing microsurgery in Yangon General Hospital, Myanmar. Sixty-four patients underwent reconstruction with free flaps from January 2015 to January 2018. All clinical records of these cases were assessed. The number of free flap reconstructions performed increased from 11 in the first year to 24 in the third year. The anterolateral thigh flap was the most commonly used (42%). The most common sites of reconstruction were mandible and intraoral defects. Total flap survival occurred in 58 of 64 patients (89%). The total salvageable flap rate for revision surgery was 66.6%; the successful revision rate was highest in 2017, with fewer complications. The flap salvage rates increased and the operative duration decreased as clinical experience improved. Establishing a microsurgical center requires a strong multidisciplinary team, clinical experience, continuous learning, sensible clinical application, and effective interdepartmental and intradepartmental cooperation. en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=Yi Yi Cho Thein kn-aut-sei=Yi Yi Cho Thein kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WinMyitzu en-aut-sei=Win en-aut-mei=Myitzu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ThuzaraMoe en-aut-sei=Thuzara en-aut-mei=Moe kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 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=5 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=6 ORCID= en-aut-name=LeungMichael en-aut-sei=Leung en-aut-mei=Michael kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Plastic, Maxillofacial and Oral Surgery, Yangon General Hospital, University of Medicine (1) kn-affil= affil-num=2 en-affil=Department of Plastic, Maxillofacial and Oral Surgery, Yangon General Hospital, University of Medicine (1) kn-affil= affil-num=3 en-affil=Department of Plastic, Maxillofacial and Oral Surgery, Yangon General Hospital, University of Medicine (1) kn-affil= affil-num=4 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Plastic and Reconstructive Surgery, 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, Monash Health kn-affil= en-keyword=microsurgery kn-keyword=microsurgery en-keyword=educational programs kn-keyword=educational programs en-keyword=challenges of microsurgical free flaps kn-keyword=challenges of microsurgical free flaps en-keyword=reoperation kn-keyword=reoperation en-keyword=flap salvageable rate kn-keyword=flap salvageable rate END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=5 article-no= start-page=399 end-page=405 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=201710 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Vaginoplasty with a Pudendal-groin Flap in Male-to-female Transsexuals en-subtitle= kn-subtitle= en-abstract= kn-abstract= Many vaginoplasty techniques have been introduced to improve the outcomes of sex reassignment surgery for male-to-female transsexuals. Some vaginoplasty patients still require additional skin grafts, making dilation mandatory to overcome shrinkage. We developed a new vaginoplasty method (called the “pudendal-groin flap”) that uses pudendal-groin flaps. One of this procedure’s advantages is that skin grafts are unnecessary, even for patients with small penises and scrotums. We introduce the procedure here and describe our evaluation of its utility. We retrospectively analyzed the cases of the 15 patients who underwent vaginoplasty using pudendal-groin flaps from May 2010 to January 2016 at our institution. We compared the complications as well as the functional and aesthetic outcomes with those of previous studies. The most common complication was bleeding, which occurred at the corpus spongiosum or while creating a new vaginal cavity. Bleeding can be reduced with more careful hemostasis and dissection. Aside from inadequate vaginal depth in one patient, the incidence of other complications, sexual intercourse, and aesthetic outcomes were acceptable. The pudendal- groin flap is thin and pliable and can create sufficient vaginal depth without skin grafts. The resulting scar is inconspicuous. Our findings suggest that vaginoplasty using the pudendal-groin flap method is feasible. en-copyright= kn-copyright= en-aut-name=MukaiYuko en-aut-sei=Mukai en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SugimotoMorito en-aut-sei=Sugimoto en-aut-mei=Morito 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= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo 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, 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 Urology, 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 Gender Center, Okayama University Hospital kn-affil= en-keyword=vaginoplasty kn-keyword=vaginoplasty en-keyword=male-to-female transsexuals kn-keyword=male-to-female transsexuals en-keyword=pudendal-groin flap kn-keyword=pudendal-groin flap END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=4 article-no= start-page=345 end-page=349 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=201708 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Cervical Spine Osteoradionecrosis en-subtitle= kn-subtitle= en-abstract= kn-abstract= Osteoradionecrosis (ORN), a well-known complication of radiotherapy in the mandibular bone, is very rare in the cervical spine. The authors report the result of a 3-year follow-up of a 63-year-old female patient with ORN of the cervical spine. The patient had a history of laryngeal carcinoma and was treated with chemotherapy and radiation therapy with a total of 120 Gy. Eight years later, she developed acute, severe neck pain due to cervical spine necrosis. The authors performed vascularized fibular bone graft and posterior pedicle screw fixation to reconstruct her cervical spine. The patient was successfully treated with surgery, and cervical alignment was preserved. She had neither neurological deficits nor severe neck pain at her final follow-up 3 years later. Delaying treatment of ORN may be life threatening, so the early diagnosis of this condition is important for patients who receive radiotherapy. Otolaryngologists and spine surgeons should understand this potential complication to speed diagnosis and treatment as early as possible. en-copyright= kn-copyright= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugimotoYoshihisa en-aut-sei=Sugimoto en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakigawaTomoyuki en-aut-sei=Takigawa en-aut-mei=Tomoyuki 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= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Orthopaedic 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 Orthopaedic Surgery, Okayama University Hospital kn-affil= en-keyword=osteoradionecrosis kn-keyword=osteoradionecrosis en-keyword=laryngeal carcinoma kn-keyword=laryngeal carcinoma en-keyword=cervical spine kn-keyword=cervical spine en-keyword=radiotherapy kn-keyword=radiotherapy END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=3 article-no= start-page=332 end-page=335 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201603 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Novel Lymphaticovenular Anastomosis Rat Model en-subtitle= kn-subtitle= en-abstract= kn-abstract=INTRODUCTION:　 Lymphaticovenular anastomosis (LVA) has become an important procedure for the surgical treatment of lymphedema. In the past, the anatomy of the lymphatic system of animal models has been reported. However, to our knowledge, there have been few reports of animal models of LVA including training model. In this study, we report on a relatively simple and ideal animal LVA model based on peritoneal lymph ducts and veins.　 PATIENTS AND METHODS:　 For 10 rats, diameters of lumbar lymphatic ducts and iliolumbar veins in the peritoneal cavity on both sides were measured, and LVA was performed. In addition, we measured the diameters of 28 lymphatic ducts and veins in 8 patients who had previously undergone LVA and compared the results with those obtained in this rat model.　 RESULTS:　 The mean diameter of the lymphatic ducts was 0.61 mm, and the iliolumbar veins were 0.81 mm. On the other hand, the mean diameters of the 28 lymphatic ducts and veins of the 8 patients in whom we performed LVA were 0.58 and 0.76 mm, respectively. The differences in the diameters of the lymph vessels and veins between the rats and patients were not statistically significant.　 CONCLUSIONS:　 We report on an LVA model involving the use of the lumbar lymphatic duct and iliolumbar veins of rats. The diameter, nature, and placement of the anastomosis using this model are very similar to that noted during real human surgery. We believe that our rat model will be useful as a practical training model for LVA and in studies on postoperative changes in LVA. 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= 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= en-keyword=anastmosis style kn-keyword=anastmosis style en-keyword=patency rate kn-keyword=patency rate en-keyword=rat kn-keyword=rat en-keyword=animal model kn-keyword=animal model en-keyword=lymphaticovenular anastomosis kn-keyword=lymphaticovenular anastomosis END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=2 article-no= start-page=288 end-page=298 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=201703 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Development of a Japanese version of the BREAST-Q and the traditional psychometric test of the mastectomy module for the assessment of HRQOL and patient satisfaction following breast surgery en-subtitle= kn-subtitle= en-abstract= kn-abstract=BACKGROUND:　 An understanding of health-related quality of life (HRQOL) is of utmost importance in both oncological and esthetic breast surgery. The BREAST-Q is a patient-reported outcome (PRO) measure that investigates HRQOL and patient satisfaction before and after breast surgery. The aim of this study was to develop a Japanese version of the BREAST-Q including the mastectomy module, the reconstruction module, the augmentation module and the reduction/mastopexy module, and to assess the psychometric properties of the mastectomy module among Japanese women.　 METHODS:　 The Japanese version of the BREAST-Q was developed through forward translation, backward translation and patient testing. Traditional psychometric testing of the mastectomy module was administered to 45 post-mastectomy patients.　 RESULTS:　 The mastectomy, reconstruction, augmentation and reduction/mastopexy modules were formally developed into Japanese. Despite cultural difference between Japanese women and original target population, the contents were considered to be valid among Japanese woman. With the exception of the sexual well-being subscale, good reliability and validity were evident for the mastectomy module (Test-retest reliability 0.76-0.95, Chronbach's alpha coefficient 0.77-0.98).　 CONCLUSIONS:　 The BREAST-Q Japanese version is a useful PRO measure for investigating the impact of breast surgery on HRQOL and patient satisfaction. Further validation in younger Japanese women is needed to determine the usefulness of the sexual well-being subscale. en-copyright= kn-copyright= en-aut-name=SaigaMiho en-aut-sei=Saiga en-aut-mei=Miho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TairaNaruto en-aut-sei=Taira en-aut-mei=Naruto 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= en-aut-name=WatanabeSatoko en-aut-sei=Watanabe en-aut-mei=Satoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MukaiYuko en-aut-sei=Mukai en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ShimozumaKojiro en-aut-sei=Shimozuma en-aut-mei=Kojiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MizooTaeko en-aut-sei=Mizoo en-aut-mei=Taeko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NogamiTomohiro en-aut-sei=Nogami en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IwamotoTakayuki en-aut-sei=Iwamoto en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MotokiTakayuki en-aut-sei=Motoki en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=ShienTadahiko en-aut-sei=Shien en-aut-mei=Tadahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MatsuokaJunji en-aut-sei=Matsuoka en-aut-mei=Junji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=DoiharaHiroyoshi en-aut-sei=Doihara en-aut-mei=Hiroyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil= 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 Plastic and Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University kn-affil= affil-num=7 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=11 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=12 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=13 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= en-keyword=BREAST-Q kn-keyword=BREAST-Q en-keyword=Breast cancer kn-keyword=Breast cancer en-keyword=Breast reconstruction kn-keyword=Breast reconstruction en-keyword=Health-related quality of life kn-keyword=Health-related quality of life en-keyword=Satisfaction kn-keyword=Satisfaction 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=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=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=128 cd-vols= no-issue=3 article-no= start-page=191 end-page=196 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=20161201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Our experience with the significance of collaborative medical and dental surgeries at the Head and Neck Cancer Center, Okayama University Hospital kn-title=岡山大学病院頭頸部がんセンターにおける医科歯科合同手術の現状解析とその意義 en-subtitle= kn-subtitle= en-abstract= kn-abstract=　　We have been collaborating with head and neck surgeons, plastic surgeons and oral surgeons in surgeries for many patients with head and neck carcinomas（ especially oral carcinomas） since 2006（ fiscal year 2005）. The Head and Neck Cancer Center was established at Okayama University Hospital in 2012. 　This Center was the first of its kind at a national university hospital in Japan. 　At the Center, 174 operations on head and neck carcinomas and 96 reconstructive operations were performed in 2014（ fiscal year）. 　Medical and dental collaborative operations have been increasing almost every year since the 2005 fiscal year. There were 45 collaborative operations in the 2014 fiscal year, which included 30 cases of bone or metal plate reconstruction or plate reinforcement of the jaws. 　There were 76 medical and dental collaborative operations in the 7 years before the establishment of the Center, with a mean of 10.9 operations per year. Since the establishment of the Center, there have been 112 cases over 3 years with a mean of 37.3 operations per year. The number of surgeries has been markedly increased by the establishment of the Head and Neck Cancer Center. en-copyright= kn-copyright= en-aut-name=MizukawaNobuyoshi en-aut-sei=Mizukawa en-aut-mei=Nobuyoshi kn-aut-name=水川展吉 kn-aut-sei=水川 kn-aut-mei=展吉 aut-affil-num=1 ORCID= en-aut-name=OnodaTomoo en-aut-sei=Onoda en-aut-mei=Tomoo kn-aut-name=小野田友男 kn-aut-sei=小野田 kn-aut-mei=友男 aut-affil-num=2 ORCID= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi kn-aut-name=松本洋 kn-aut-sei=松本 kn-aut-mei=洋 aut-affil-num=3 ORCID= en-aut-name=TakedaSeiko en-aut-sei=Takeda en-aut-mei=Seiko kn-aut-name=武田斉子 kn-aut-sei=武田 kn-aut-mei=斉子 aut-affil-num=4 ORCID= en-aut-name=NodaYouhei en-aut-sei=Noda en-aut-mei=Youhei kn-aut-name=野田洋平 kn-aut-sei=野田 kn-aut-mei=洋平 aut-affil-num=5 ORCID= en-aut-name=OnodaSatoshi en-aut-sei=Onoda en-aut-mei=Satoshi kn-aut-name=小野田聡 kn-aut-sei=小野田 kn-aut-mei=聡 aut-affil-num=6 ORCID= en-aut-name=FukushimaMai en-aut-sei=Fukushima en-aut-mei=Mai kn-aut-name=福島麻衣 kn-aut-sei=福島 kn-aut-mei=麻衣 aut-affil-num=7 ORCID= en-aut-name=TsumuraMunechika en-aut-sei=Tsumura en-aut-mei=Munechika kn-aut-name=津村宗近 kn-aut-sei=津村 kn-aut-mei=宗近 aut-affil-num=8 ORCID= en-aut-name=TakeuchiTetsuo en-aut-sei=Takeuchi en-aut-mei=Tetsuo kn-aut-name=竹内哲男 kn-aut-sei=竹内 kn-aut-mei=哲男 aut-affil-num=9 ORCID= en-aut-name=SugiyamaNarushi en-aut-sei=Sugiyama en-aut-mei=Narushi kn-aut-name=杉山成史 kn-aut-sei=杉山 kn-aut-mei=成史 aut-affil-num=10 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=11 ORCID= affil-num=1 en-affil=Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター， 顎口腔再建外科 affil-num=2 en-affil=Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，耳鼻咽喉・頭頸部外科 affil-num=3 en-affil=Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，形成外科 affil-num=4 en-affil=Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，顎口腔再建外科 affil-num=5 en-affil=Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，耳鼻咽喉・頭頸部外科 affil-num=6 en-affil=Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，形成外科 affil-num=7 en-affil=Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，顎口腔再建外科 affil-num=8 en-affil=Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，耳鼻咽喉・頭頸部外科 affil-num=9 en-affil=Departments of Dental Laboratory, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，歯科技工室 affil-num=10 en-affil=Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，形成外科 affil-num=11 en-affil=Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital kn-affil=岡山大学病院　頭頸部がんセンター，形成外科 en-keyword=頭頸部がん（head and neck carcinoma） kn-keyword=頭頸部がん（head and neck carcinoma） en-keyword=口腔がん（oral carcinoma） kn-keyword=口腔がん（oral carcinoma） en-keyword=頭頸部がんセンター（Head and Neck Cancer Center） kn-keyword=頭頸部がんセンター（Head and Neck Cancer Center） en-keyword=医科歯科合同手術（collaborative medical and dental surgeries） kn-keyword=医科歯科合同手術（collaborative medical and dental surgeries） en-keyword=顎骨再建（reconstructive operations of the jaw） kn-keyword=顎骨再建（reconstructive operations of the jaw） END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=3 article-no= start-page=205 end-page=211 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201606 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Structure of a New Palatal Plate and the Artificial Tongue for Articulation Disorder in a Patient with Subtotal Glossectomy en-subtitle= kn-subtitle= en-abstract= kn-abstract=A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech and swallowing functions of patients with tongue resection or tongue movement disorders. However, a PAPʼs effect is limited in cases where articulation disorder is severe due to wide glossectomy and/or segmental mandibulectomy. In this paper, we describe speech outcomes of a patient with an articulation disorder following glossectomy and segmental mandibulectomy. We used a palatal plate (PP) based on a PAP, along with an artificial tongue (KAT). Speech improvement was evaluated by a standardized speech intelligibility test consisting of 100 syllables. The speech intelligibility score was significantly higher when the patient wore both the PP and KAT than when he wore neither (p＝0.013). The conversational intelligibility score was significantly improved with the PP and KAT than without PP and KAT (p＝0.024). These results suggest that speech function can be improved in patients with hard tissue defects with segmental mandibulectomy using both a PP and a KAT. The nature of the design of the PP and that of the KAT will allow these prostheses to address a wide range of tissue defects. en-copyright= kn-copyright= en-aut-name=KozakiKen-ichi en-aut-sei=Kozaki en-aut-mei=Ken-ichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KawakamiShigehisa en-aut-sei=Kawakami en-aut-mei=Shigehisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KonishiTakayuki en-aut-sei=Konishi en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OhtaKeiji en-aut-sei=Ohta en-aut-mei=Keiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YanoJitsuro en-aut-sei=Yano en-aut-mei=Jitsuro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OnodaTomoo en-aut-sei=Onoda en-aut-mei=Tomoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MizukawaNobuyoshi en-aut-sei=Mizukawa en-aut-mei=Nobuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 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=9 ORCID= en-aut-name=NishizakiKazunori en-aut-sei=Nishizaki en-aut-mei=Kazunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=IidaSeiji en-aut-sei=Iida en-aut-mei=Seiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=GofukuAkio en-aut-sei=Gofuku en-aut-mei=Akio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=AbeMasanobu en-aut-sei=Abe en-aut-mei=Masanobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=MinagiShogo en-aut-sei=Minagi en-aut-mei=Shogo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=Okayama Dream Speech Project en-aut-sei=Okayama Dream Speech Project en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= affil-num=1 en-affil=Department of Dental Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Division of Physical Medicine and Rehabilitation, Okayama University Hospital kn-affil= affil-num=4 en-affil=Dental Laboratory Division, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Otolaryngology-Head and Neck 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 Oral and Maxillofacial Reconstructive Surgery, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Otolaryngology-Head and Neck Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Graduate School of Natural Science and Technology, Okayama University kn-affil= affil-num=13 en-affil=Department of Computer Science, Okayama University kn-affil= affil-num=14 en-affil=Department of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil= kn-affil= en-keyword=palatal augmentation prosthesis kn-keyword=palatal augmentation prosthesis en-keyword=artificial tongue kn-keyword=artificial tongue en-keyword=articulation disorder kn-keyword=articulation disorder en-keyword=glossectomy kn-keyword=glossectomy en-keyword=mandibulectomy kn-keyword=mandibulectomy END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=7 article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=20140721 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Neutral Self-Assembling Peptide Hydrogel SPG-178 as a Topical Hemostatic Agent en-subtitle= kn-subtitle= en-abstract= kn-abstract=Conventional self-assembling peptide hydrogels are effective as topical hemostatic agents. However, there is a possibility to harm living tissues due to their low pH. The aim of the present study was to demonstrate the efficacy of SPG-178, a neutral self-assembling peptide hydrogel, as a topical hemostatic agent. First, we measured the bleeding duration of incisions made on rat livers after application of SPG-178 (1.0% w/v), SPG-178 (1.5% w/v), RADA16 (1.0% w/v), and saline (n = 12/group). Second, we observed the bleeding surfaces by transmission electron microscopy immediately after hemostasis. Third, we measured the elastic and viscous responses (G′ and G″, respectively) of the hydrogels using a rheometer. Our results showed that bleeding duration was significantly shorter in the SPG-178 group than in the RADA16 group and that there were no significant differences in transmission electron microscopy findings between the groups. The greater the G′ value of a hydrogel, the shorter was the bleeding duration. We concluded that SPG-178 is more effective and has several advantages: it is non-biological, transparent, nonadherent, and neutral and can be sterilized by autoclaving. 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=NagaiYusuke en-aut-sei=Nagai en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NaruseKeiji en-aut-sei=Naruse en-aut-mei=Keiji 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= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama Saiseikai General Hospital affil-num=2 en-affil= kn-affil=Department of Cardiovascular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Cardiovascular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=3 article-no= start-page=183 end-page=190 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=201406 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=For Vol.67, No.5 pp325-331 Phalloplasty with an Innervated Island Pedicled Anterolateral Thigh Flap in a Female-to-Male Transsexual en-subtitle= kn-subtitle= en-abstract= kn-abstract=Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the “tube within a tube” technique, in which the penis and urethra are constructed with a single flap. As compared to a forearm flap, use of an innervated islandpedicled flap may have the following advantages in phalloplasty: 1) no need for a microsurgical technique; 2) no scars at noticeable sites; 3) small functional loss in the flap donor area; 4) no sacrifice of major blood vessels. Thus, this technique seems to be a useful clinical alternative for phallic reconstruction. en-copyright= kn-copyright= en-aut-name=HasegawaKenjiro en-aut-sei=Hasegawa en-aut-mei=Kenjiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo 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= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=gender identity disorder kn-keyword=gender identity disorder en-keyword=sex reassignment surgery (SRS) kn-keyword=sex reassignment surgery (SRS) en-keyword=phalloplasty kn-keyword=phalloplasty END 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=67 cd-vols= no-issue=6 article-no= start-page=391 end-page=395 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201312 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Thumb Polydactyly with a Floating Ulnar Thumb en-subtitle= kn-subtitle= en-abstract= kn-abstract=Thumb polydactyly is reported to be the most common congenital anomaly of the hand in Japan. The floating type is not particularly rare, accounting for 0.9 to 15% of all cases of thumb polydactyly. However, to the best of our knowledge, there has been only one case of thumb polydactyly with a floating ulnar thumb, reported by Onizuka. Herein, we report a case very similar to that reported by Onizuka. In our case, the vessels feeding the floating ulnar thumb branched from the superficial palmar arterial arch, and X-rays revealed triphalangism. In surgery, we not only reconstructed the morphology of the thumb, but also tried to preserve the sensation in the reconstructed thumb by transposing the digital nerve of the floating ulnar thumb to the radial thumb. In addition to thumb polydactyly, our case also showed hypoplasia of the thenar muscles. en-copyright= kn-copyright= en-aut-name=HasegawaKenjiro en-aut-sei=Hasegawa en-aut-mei=Kenjiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo 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= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=polydactyly kn-keyword=polydactyly en-keyword=floating ulnar thumb kn-keyword=floating ulnar thumb en-keyword=thumb hypoplasia kn-keyword=thumb hypoplasia END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue=5 article-no= start-page=325 end-page=331 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201310 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Phalloplasty with an Innervated Island Pedicled Anterolateral Thigh Flap in a Female-to-Male Transsexual en-subtitle= kn-subtitle= en-abstract= kn-abstract=Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the "tube within a tube" technique, in which the penis and urethra are constructed with a single flap. While phalloplasty with an island-pedicled or free anterolateral thigh flap has been reported previously, the present case seems to be the first of phalloplasty with an innervated island-pedicled anterolateral thigh flap using the "tube within a tube" technique. As compared to a forearm flap, use of an innervated island-pedicled flap may have the following advantages in phalloplasty:1) no need for a microsurgical technique;2) no scars at noticeable sites;3) small functional loss in the flap donor area;4) no sacrifice of major blood vessels. Thus, this technique seems to be a useful clinical alternative for phallic reconstruction. en-copyright= kn-copyright= en-aut-name=HasegawaKenjiro en-aut-sei=Hasegawa en-aut-mei=Kenjiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo 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= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=gender identity disorder kn-keyword=gender identity disorder en-keyword=sex reassignment surgery (SRS) kn-keyword=sex reassignment surgery (SRS) en-keyword=phalloplasty kn-keyword=phalloplasty END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue=4 article-no= start-page=271 end-page=276 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201308 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Negative Pressure Wound Therapy Incorporating Early Exercise Therapy in Hand Surgery:Bag-type Negative Pressure Wound Therapy en-subtitle= kn-subtitle= en-abstract= kn-abstract=In the postoperative treatment of hand surgery, it is important to start exercise therapy as early as possible. In conventional negative pressure wound therapy, the fingers are immobilized by the film dressing covering the wound and hand, thereby preventing sufficient rehabilitation. Here, we devised a bag-type negative pressure wound therapy that makes it possible to start finger exercises almost immediately, and we applied it to 4 patients:one each with hand burns, symmetrical peripheral gangrene, a crush injury accompanied by extensive skin defects and a fingertip degloving injury. The duration of the bag-type negative pressure wound therapy ranged from three to eight weeks, and good granulation was achieved, so that a skin graft was not required. In addition, particularly in the case of the fingertip degloving injury, good nail regeneration was achieved. Except for the case of symmetrical peripheral gangrene, a good range of joint motion with a percent total active motion (%TAM) of 94.7% or more was achieved. Our therapy was performed by inserting the hand into a sealing bag;sufficient exercise therapy was made possible by expanding the bag during rehabilitation. en-copyright= kn-copyright= en-aut-name=HasegawaKenjiro en-aut-sei=Hasegawa en-aut-mei=Kenjiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo 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= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=negative pressure wound therapy kn-keyword=negative pressure wound therapy en-keyword=early exercise therapy kn-keyword=early exercise therapy en-keyword=wound healing kn-keyword=wound healing en-keyword=hand surgery kn-keyword=hand surgery END start-ver=1.4 cd-journal=joma no-vol=65 cd-vols= no-issue=3 article-no= start-page=215 end-page=218 dt-received= dt-revised= dt-accepted= dt-pub-year=2011 dt-pub=201106 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Churg-Strauss Syndrome with Necrosis of Toe Tips en-subtitle= kn-subtitle= en-abstract= kn-abstract=Churg-Strauss syndrome (CSS) is a granulomatous necrotizing vasculitis of unknown etiology associated with bronchial asthma. Despite affecting small to medium-sized vessels, necrosis of the digits due to vasculitis is extremely rare. We report a case of CSS with necrosis of the toe tips. A 37-year-old woman with asthma, who had been diagnosed with CSS 2 years ago, was admitted to our hospital with an exacerbation of CSS. The patient had a high grade fever and complained of abdominal pain and numbness of the lower extremities. Blood examination revealed marked eosinophilia. The fever pattern, abdominal pain and blood eosinophilia showed improvement by combination treatment with prednisolone and cyclophosphamide. However, the color of her right toe tips changed, and necrosis finally resulted despite antithrombotic therapy. Arteriography showed narrowing of the dorsalis pedis artery and of the more peripheral arteries of her right leg. Stump plasty with negative pressure dressing therapy for the toe tips, but not amputation, was done to preserve the leg function. While numbness of the extremities remained, no recurrence of necrosis was seen. Clinicians need to be aware that rare complications of CSS, including necrosis of the digits, can occur. en-copyright= kn-copyright= en-aut-name=WasedaKoichi en-aut-sei=Waseda en-aut-mei=Koichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 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=2 ORCID= en-aut-name=HasegawaKenjiro en-aut-sei=Hasegawa en-aut-mei=Kenjiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MiyaharaNobuaki en-aut-sei=Miyahara en-aut-mei=Nobuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NojimaDaisuke en-aut-sei=Nojima en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=IkedaGenyo en-aut-sei=Ikeda en-aut-mei=Genyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KanehiroArihiko en-aut-sei=Kanehiro en-aut-mei=Arihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OkadaChiharu en-aut-sei=Okada en-aut-mei=Chiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 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=9 ORCID= en-aut-name=TanimotoMitsune en-aut-sei=Tanimoto en-aut-mei=Mitsune kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Department of Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Plastic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Allergy, National Hospital Organization Minami-Okayama Medical Center affil-num=9 en-affil= kn-affil=Department of Plastic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Department of Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=bronchial asthma kn-keyword=bronchial asthma en-keyword=Churg-Strauss syndrome kn-keyword=Churg-Strauss syndrome en-keyword=eosinophilia kn-keyword=eosinophilia en-keyword=necrosis of toe tips kn-keyword=necrosis of toe tips en-keyword=stump plasty kn-keyword=stump plasty END start-ver=1.4 cd-journal=joma no-vol=61 cd-vols= no-issue=6 article-no= start-page=355 end-page=360 dt-received= dt-revised= dt-accepted= dt-pub-year=2007 dt-pub=200712 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Vaginoplasty with an M-Shaped Perineo- Scrotal Flap in a Male-to-female Transsexual en-subtitle= kn-subtitle= en-abstract= kn-abstract=

To date, many techniques have been reported for vaginoplasty in male-to-female trans-sexual (MTFTS) patients, such as the use of a rectum transfer, a penile-scrotal flap and a reversed penile flap. However, none of these procedures is without its disadvantages. We developed a newly kind of flap for vaginoplasty, the M-shaped perineo-scrotal flap (M-shaped flap), using skin from both sides of the scrotum, shorn of hair by preoperative laser treatment. We applied this new type of flap in 7 MTFTS patients between January 2006 and January 2007. None of the flaps developed necrosis, and the patients could engage in sexual activity within 3 months of the operation. The M-shaped flap has numerous advantages: it can be elevated safely while retaining good vascularity, it provides for the construction of a sufficient deep vagina without a skin graft, the size of the flap is not influenced entirely by the length of the penis, and it utilizes skin from both sides of the scrotal area, which is usually excised.

en-copyright= kn-copyright= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiyamaNarushi en-aut-sei=Sugiyama en-aut-mei=Narushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamashitaShuji en-aut-sei=Yamashita en-aut-mei=Shuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HasegawaKenjiro en-aut-sei=Hasegawa en-aut-mei=Kenjiro 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=IshiiKazushi en-aut-sei=Ishii en-aut-mei=Kazushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University affil-num=6 en-affil= kn-affil=Okayama University affil-num=7 en-affil= kn-affil=Okayama University en-keyword=vaginoplasty kn-keyword=vaginoplasty en-keyword=male-to-female transsexual kn-keyword=male-to-female transsexual en-keyword=perineo-scrotal flap kn-keyword=perineo-scrotal flap END start-ver=1.4 cd-journal=joma no-vol=59 cd-vols= no-issue=5 article-no= start-page=231 end-page=233 dt-received= dt-revised= dt-accepted= dt-pub-year=2005 dt-pub=200510 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Sex reassignment surgery for male to female transsexuals: initial experience in Okayama university hospital. en-subtitle= kn-subtitle= en-abstract= kn-abstract=

The first case of sex reassignment surgery (SRS) in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and wound dehiscence. Although ours is only an initial experience, we describe our surgical technique herein.

en-copyright= kn-copyright= en-aut-name=NagaiAtsushi en-aut-sei=Nagai en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TokuyamaEijirou en-aut-sei=Tokuyama en-aut-mei=Eijirou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NanbaYuzaburo en-aut-sei=Nanba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TsutsuiTetsuya en-aut-sei=Tsutsui en-aut-mei=Tetsuya 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=NakatsukaMikiya en-aut-sei=Nakatsuka en-aut-mei=Mikiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KoshimaIsao en-aut-sei=Koshima en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SaikaTakashi en-aut-sei=Saika en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KumonHiromi en-aut-sei=Kumon en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University affil-num=6 en-affil= kn-affil=Okayama University affil-num=7 en-affil= kn-affil=University of Tokyo, Tokyo affil-num=8 en-affil= kn-affil=Okayama University affil-num=9 en-affil= kn-affil=Okayama University affil-num=10 en-affil= kn-affil=Okayama University en-keyword=gender identity disorder kn-keyword=gender identity disorder en-keyword=sex reassignment surgery kn-keyword=sex reassignment surgery en-keyword=male to female transsexual kn-keyword=male to female transsexual END start-ver=1.4 cd-journal=joma no-vol=63 cd-vols= no-issue=5 article-no= start-page=243 end-page=247 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=200910 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Mastectomy in Female-to-male Transsexuals en-subtitle= kn-subtitle= en-abstract= kn-abstract=

The first operative procedure in sex reassignment surgery (SRS) for female-to-male transsexuals (FTMTS) is mastectomy. This procedure includes the removal of mammary tissue, removal of excess skin, and reduction and proper repositioning of the nipple and areola complex. We have performed mastectomies in over 120 patients since January 2001 and want to describe the operative procedures we have developed. We classified our patients into 3 groups according to the patient's breast volume and the degree of ptosis, and we selected the operative procedure that was suitable for each group. At present all costs for SRS are assumed by the patient in Japan. If the FTMTS patient undergoes the entire series of SRS operations, he has to pay more than 3,000,000 yen. Thus the surgeon should select the proper operative procedure so that the patient can avoid unnecessary additional operations. We describe herein the techniques and the strategy for performing mastectomy in FTMTS.

en-copyright= kn-copyright= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeToshiyuki en-aut-sei=Watanabe en-aut-mei=Toshiyuki 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= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=mastectomy kn-keyword=mastectomy en-keyword=female-to-male transsexual kn-keyword=female-to-male transsexual en-keyword=sex reassignment surgery kn-keyword=sex reassignment surgery END start-ver=1.4 cd-journal=joma no-vol=62 cd-vols= no-issue=3 article-no= start-page=213 end-page=216 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=200806 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Phantom erectile penis after sex reassignment surgery en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Between January 2001 and December 2007, we performed vaginoplasty as sex reassignment surgery in a total of 14 male-to-female transsexual (MTFTS) patients [1]. Several complications occurred such as partial flap necrosis, rectovaginal fistula formation and hypersensitivity of the neoclitoris. Just after the operation, some patients feel that their penises still exist, but by several weeks postoperatively, this sensation has disappeared. Herein we report a case of MTFTS in whom the sensation of a phantom erectile penis persisted for much longer.

en-copyright= kn-copyright= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiyamaNarushi en-aut-sei=Sugiyama en-aut-mei=Narushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamashitaShuji en-aut-sei=Yamashita en-aut-mei=Shuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 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=4 ORCID= en-aut-name=HasegawaKenjiro en-aut-sei=Hasegawa en-aut-mei=Kenjiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 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=6 ORCID= affil-num=1 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=gender identity disorder kn-keyword=gender identity disorder en-keyword=sex reassignment surgery kn-keyword=sex reassignment surgery en-keyword=phantom erectile penis kn-keyword=phantom erectile penis END start-ver=1.4 cd-journal=joma no-vol=62 cd-vols= no-issue=6 article-no= start-page=415 end-page=419 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=200812 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Vaginoplasty with a Pudendal-Thigh Flap in Intersexuals en-subtitle= kn-subtitle= en-abstract= kn-abstract=

We treated 2 different types of intersexual patients who underwent a vaginoplasty with the pudendal-thigh flap. One was a female with testicular feminization syndrome for whom we reconstructed the total vagina with a pudendal-thigh flap, and the other was a female with an adrenogenital syndrome for whom we enlarged the introitus of the vagina with the same approach. There were no complications such as a flap necrosis. In addition, there was no stricture of the neo-vagina and no urinary problem.

en-copyright= kn-copyright= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiyamaNarushi en-aut-sei=Sugiyama en-aut-mei=Narushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamashitaShuji en-aut-sei=Yamashita en-aut-mei=Shuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HasegawaKenjiro en-aut-sei=Hasegawa en-aut-mei=Kenjiro 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=NakatsukaMikiya en-aut-sei=Nakatsuka en-aut-mei=Mikiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil= Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Gynecology and Obstetrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=vaginoplasty kn-keyword=vaginoplasty en-keyword=intersexual kn-keyword=intersexual en-keyword=pudendal-thigh flap kn-keyword=pudendal-thigh flap END start-ver=1.4 cd-journal=joma no-vol=60 cd-vols= no-issue=4 article-no= start-page=233 end-page=236 dt-received= dt-revised= dt-accepted= dt-pub-year=2006 dt-pub=200608 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Fibular osteoadiposal flap for treatment of tibial adamantinoma: a case report. en-subtitle= kn-subtitle= en-abstract= kn-abstract=We treated a case with left tibial adamantinoma by use of a contralateral fibular osteoadiposal flap. The donor site of conventional fibular osteocutaneous flap must be covered with a skin graft because if we close the donor skin defect directly, compartment syndrome might occur. We were able to close the donor skin defect because this combined type flap included only a small monitoring skin paddle. We present herein the utility of the osteoadiposal flap and show the value of a skin-sparing approach with a minimal aesthetic defect. en-copyright= kn-copyright= en-aut-name=NambaYuzaburo en-aut-sei=Namba en-aut-mei=Yuzaburo 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=KoshimaIsao en-aut-sei=Koshima en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SugiharaShinsuke en-aut-sei=Sugihara en-aut-mei=Shinsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SatoTohru en-aut-sei=Sato en-aut-mei=Tohru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=University of Tokyo, Tokyo affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University en-keyword=adamantinoma kn-keyword=adamantinoma en-keyword=fibular osteoadiposal flap kn-keyword=fibular osteoadiposal flap en-keyword=skin-sparing flap harvest kn-keyword=skin-sparing flap harvest END start-ver=1.4 cd-journal=joma no-vol=122 cd-vols= no-issue=1 article-no= start-page=55 end-page=59 dt-received= dt-revised= dt-accepted= dt-pub-year=2010 dt-pub=20100401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Interventional radiology for vascular anomalies kn-title=血管腫・血管奇形に対するinterventional radiology en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=MimuraHidefumi en-aut-sei=Mimura en-aut-mei=Hidefumi kn-aut-name=三村秀文 kn-aut-sei=三村 kn-aut-mei=秀文 aut-affil-num=1 ORCID= en-aut-name=FujiwaraHiroyasu en-aut-sei=Fujiwara en-aut-mei=Hiroyasu kn-aut-name=藤原寛康 kn-aut-sei=藤原 kn-aut-mei=寛康 aut-affil-num=2 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name=平木隆夫 kn-aut-sei=平木 kn-aut-mei=隆夫 aut-affil-num=3 ORCID= en-aut-name=GobaraHideo en-aut-sei=Gobara en-aut-mei=Hideo kn-aut-name=郷原英夫 kn-aut-sei=郷原 kn-aut-mei=英夫 aut-affil-num=4 ORCID= en-aut-name=ShibamotoKentaro en-aut-sei=Shibamoto en-aut-mei=Kentaro kn-aut-name=芝本健太郎 kn-aut-sei=芝本 kn-aut-mei=健太郎 aut-affil-num=5 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=6 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name=尾﨑敏文 kn-aut-sei=尾﨑 kn-aut-mei=敏文 aut-affil-num=7 ORCID= en-aut-name=SasakiSatoru en-aut-sei=Sasaki en-aut-mei=Satoru kn-aut-name=佐々木了 kn-aut-sei=佐々木 kn-aut-mei=了 aut-affil-num=8 ORCID= en-aut-name=KanazawaSusumu en-aut-sei=Kanazawa en-aut-mei=Susumu kn-aut-name=金澤右 kn-aut-sei=金澤 kn-aut-mei=右 aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　放射線医学 affil-num=2 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　放射線医学 affil-num=3 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　放射線医学 affil-num=4 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　放射線医学 affil-num=5 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　放射線医学 affil-num=6 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　形成再建外科学 affil-num=7 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　整形外科学 affil-num=8 en-affil= kn-affil=斗南病院形成外科 affil-num=9 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　放射線医学 en-keyword=血管奇形 kn-keyword=血管奇形 en-keyword=静脈奇形 kn-keyword=静脈奇形 en-keyword=動静脈奇形 kn-keyword=動静脈奇形 en-keyword=塞栓術 kn-keyword=塞栓術 en-keyword=硬化療法 kn-keyword=硬化療法 END start-ver=1.4 cd-journal=joma no-vol=121 cd-vols= no-issue=1 article-no= start-page=17 end-page=24 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=20090401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Two cases of mandibular and masticatory reconstruction with vascularized fibra bone flaps and implants kn-title=血管柄付腓骨皮弁移植とインプラントによる顎骨咬合再建の２例 en-subtitle= kn-subtitle= en-abstract= kn-abstract=　Defects of the jawbone have conventionally been repaired using free bone grafts and metallic plates, but patients undergoing reconstruction using these materials experience difficulty using dentures and restoring masticatory function. The use of vascularized bone grafts, which has recently been enabled, has improved bone graft survival rates, and its combination with dental implants has enabled both morphological and functional reconstruction, leading to a higher quality of life. 　We experienced two patients with tumors of the jaw that were treated by resecting and reconstructing it using a vascularized bone graft with the cooperation of the Department of Plastic Surgery in the School of Medicine. We subsequently inserted dental implants, and the superstructure was created by the Department of Prosthetics. We report the course of these patients, who achieved sufficient jaw morphology as well as masticatory function and who are presently satisfied overall three years to three years and nine months postoperatively. en-copyright= kn-copyright= en-aut-name=TakagiShin en-aut-sei=Takagi en-aut-mei=Shin kn-aut-name=高木愼 kn-aut-sei=高木 kn-aut-mei=愼 aut-affil-num=1 ORCID= en-aut-name=MizukawaNobuyoshi en-aut-sei=Mizukawa en-aut-mei=Nobuyoshi kn-aut-name=水川展吉 kn-aut-sei=水川 kn-aut-mei=展吉 aut-affil-num=2 ORCID= en-aut-name=FukunagaJoji en-aut-sei=Fukunaga en-aut-mei=Joji kn-aut-name=福永城司 kn-aut-sei=福永 kn-aut-mei=城司 aut-affil-num=3 ORCID= en-aut-name=IshidaNobuhisa en-aut-sei=Ishida en-aut-mei=Nobuhisa kn-aut-name=石田展久 kn-aut-sei=石田 kn-aut-mei=展久 aut-affil-num=4 ORCID= en-aut-name=MaruoYukinori en-aut-sei=Maruo en-aut-mei=Yukinori kn-aut-name=丸尾幸憲 kn-aut-sei=丸尾 kn-aut-mei=幸憲 aut-affil-num=5 ORCID= en-aut-name=KannyamaManabu en-aut-sei=Kannyama en-aut-mei=Manabu kn-aut-name=完山学 kn-aut-sei=完山 kn-aut-mei=学 aut-affil-num=6 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股啓裕 kn-aut-sei=木股 kn-aut-mei=啓裕 aut-affil-num=7 ORCID= en-aut-name=KoushimaIsao en-aut-sei=Koushima en-aut-mei=Isao kn-aut-name=光嶋勲 kn-aut-sei=光嶋 kn-aut-mei=勲 aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬総合研究科　顎口腔再建外科学 affil-num=2 en-affil= kn-affil=岡山大学医学部歯学部附属病院　口腔外科（再建系） affil-num=3 en-affil= kn-affil=姫路市 affil-num=4 en-affil= kn-affil=岡山大学医学部歯学部附属病院　口腔外科（再建系） affil-num=5 en-affil= kn-affil=岡山大学大学院医歯薬総合研究科　咬合・有床義歯補綴学 affil-num=6 en-affil= kn-affil=岡山大学大学院医歯薬総合研究科　インプラント再生補綴学 affil-num=7 en-affil= kn-affil=岡山大学大学院医歯薬総合研究科　形成再建外科学 affil-num=8 en-affil= kn-affil=東京大学大学院医学系研究科　感覚・運動機能医学 en-keyword=血管柄付骨移植　（vascularized bone graft） kn-keyword=血管柄付骨移植　（vascularized bone graft） en-keyword=顎骨再建　（mandibular reconstruction） kn-keyword=顎骨再建　（mandibular reconstruction） en-keyword=インプラント　（implant） kn-keyword=インプラント　（implant） en-keyword=咬合再建　（occlusal reconstruction） kn-keyword=咬合再建　（occlusal reconstruction） END start-ver=1.4 cd-journal=joma no-vol=120 cd-vols= no-issue=3 article-no= start-page=299 end-page=305 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20081201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The collaborative role of oral surgery with plastic as well as head & neck surgery in head and neck cancers : Preoperative plate-bending method in cases with mandibular reconstruction using plaster 3D models kn-title=頭頸部癌における頭頸部外科，形成外科，口腔外科３科合同手術における口腔外科の役割：下顎再建症例における３Ｄ石膏造形モデルを利用した術前プレート屈曲法 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The collaboration of various medical teams is crucial for the appropriate treatment of cancer patients. However, in Japan, it is very difficult for oral surgeons to cooperate with head and neck surgeons due to conflicts in the treatment of those patients. There have been few studies on this subject. In the current work, we report on the collaboration of head and neck surgeons, plastic surgeons and oral surgeons in operations on two patients with gingival carcinomas in the mandible. We first prepared plaster 3D models of the patients'mouths by means of ink-jet from CT data. We pre-bent the reconstruction plates using the preoperative 3D models. Therefore, we could save the time required to bend the plate. Plaster models are cheaper than resin models. It is also easy to model the surgery using the plate. During the operation, head and neck surgeons resected the tumors, plastic surgeons performed reconstruction with vascularized bone or skin graft, and oral surgeons (dentists) did plate fixation and took charge of the patients'occlusion. This method resulted in patients having good occlusion after the operation. en-copyright= kn-copyright= en-aut-name=MizukawaNobuyoshi en-aut-sei=Mizukawa en-aut-mei=Nobuyoshi kn-aut-name=水川展吉 kn-aut-sei=水川 kn-aut-mei=展吉 aut-affil-num=1 ORCID= en-aut-name=TominagaSusumu en-aut-sei=Tominaga en-aut-mei=Susumu kn-aut-name=冨永進 kn-aut-sei=冨永 kn-aut-mei=進 aut-affil-num=2 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=3 ORCID= en-aut-name=OnodaTomoo en-aut-sei=Onoda en-aut-mei=Tomoo kn-aut-name=小野田友男 kn-aut-sei=小野田 kn-aut-mei=友男 aut-affil-num=4 ORCID= en-aut-name=SugiyamaNarushi en-aut-sei=Sugiyama en-aut-mei=Narushi kn-aut-name=杉山成史 kn-aut-sei=杉山 kn-aut-mei=成史 aut-affil-num=5 ORCID= en-aut-name=YamachikaEiki en-aut-sei=Yamachika en-aut-mei=Eiki kn-aut-name=山近英樹 kn-aut-sei=山近 kn-aut-mei=英樹 aut-affil-num=6 ORCID= en-aut-name=YamadaYousuke en-aut-sei=Yamada en-aut-mei=Yousuke kn-aut-name=山田庸介 kn-aut-sei=山田 kn-aut-mei=庸介 aut-affil-num=7 ORCID= en-aut-name=KimuraTakuji en-aut-sei=Kimura en-aut-mei=Takuji kn-aut-name=木村卓爾 kn-aut-sei=木村 kn-aut-mei=卓爾 aut-affil-num=8 ORCID= en-aut-name=TakeuchiTetsuo en-aut-sei=Takeuchi en-aut-mei=Tetsuo kn-aut-name=竹内哲男 kn-aut-sei=竹内 kn-aut-mei=哲男 aut-affil-num=9 ORCID= en-aut-name=UenoTakaaki en-aut-sei=Ueno en-aut-mei=Takaaki kn-aut-name=植野高章 kn-aut-sei=植野 kn-aut-mei=高章 aut-affil-num=10 ORCID= en-aut-name=TakagiShin en-aut-sei=Takagi en-aut-mei=Shin kn-aut-name=高木慎 kn-aut-sei=高木 kn-aut-mei=慎 aut-affil-num=11 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院　口腔外科再建系 affil-num=2 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　耳鼻咽喉・頭頸部外科学 affil-num=3 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　形成再建外科学 affil-num=4 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　耳鼻咽喉・頭頸部外科学 affil-num=5 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　形成再建外科学 affil-num=6 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　顎口腔再建外科学 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院　口腔外科病態系 affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院　口腔外科病態系 affil-num=9 en-affil= kn-affil=岡山大学医学部・歯学部附属病院　医療技術部歯科系部門技工室 affil-num=10 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　顎口腔再建外科学 affil-num=11 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　顎口腔再建外科学 en-keyword=チーム医療 (medical team approach) kn-keyword=チーム医療 (medical team approach) en-keyword=頭頸部癌 (head and neck carcinoma) kn-keyword=頭頸部癌 (head and neck carcinoma) en-keyword=３Ｄ石膏モデル (plaster 3D model) kn-keyword=３Ｄ石膏モデル (plaster 3D model) en-keyword=インクジェット法 (ink-jet method) kn-keyword=インクジェット法 (ink-jet method) en-keyword=下顎再建 (mandibular reconstruction) kn-keyword=下顎再建 (mandibular reconstruction) END start-ver=1.4 cd-journal=joma no-vol=119 cd-vols= no-issue=3 article-no= start-page=267 end-page=272 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080104 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A collaborative approach to head and neck carcinoma for oral surgeons, head and neck surgeons, and plastic surgeons: The role of oral surgeons in two cases kn-title=頭頸部癌における耳鼻咽喉科, 形成外科, 口腔外科3科合同手術の意義 : 2症例における口腔外科の役割を中心に en-subtitle= kn-subtitle= en-abstract= kn-abstract=There is a medical team approach used in many hospitals for oral cancer patients. The members are head & neck surgeons and plastic surgeons, or oral surgeons and plastic surgeons. However, in Japan, it is very difficult for oral surgeons to cooperate with head & neck surgeons, except in the case of extractions and oral health care, because both surgeons treat oral carcinomas and there is therefore a conflict in their scope of practice. We believe it desirable for head & neck surgeons to treat oral cancer patients with tumors extending to other regions, and oral surgeons should be in charge of occlusion in head and neck carcinomas. We treated two patients with oral carcinomas in collaboration with head and neck surgeons and plastic surgeons, with head & neck surgeons resecting the tumors, plastic surgeons reconstructing, and oral surgeons (dentists) taking charge of the occlusion for patients in the operating room. This collaboration resulted in patients having good position of the temporomandibular joint and occlusions after the operation. We therefore conclude that this collaborative team approach may be of benefit to the patients. en-copyright= kn-copyright= en-aut-name=MizukawaNobuyoshi en-aut-sei=Mizukawa en-aut-mei=Nobuyoshi kn-aut-name=水川展吉 kn-aut-sei=水川 kn-aut-mei=展吉 aut-affil-num=1 ORCID= en-aut-name=TominagaSusumu en-aut-sei=Tominaga en-aut-mei=Susumu kn-aut-name=冨永進 kn-aut-sei=冨永 kn-aut-mei=進 aut-affil-num=2 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name=木股敬裕 kn-aut-sei=木股 kn-aut-mei=敬裕 aut-affil-num=3 ORCID= en-aut-name=OnodaTomoo en-aut-sei=Onoda en-aut-mei=Tomoo kn-aut-name=小野田友男 kn-aut-sei=小野田 kn-aut-mei=友男 aut-affil-num=4 ORCID= en-aut-name=NomiyaShigenobu en-aut-sei=Nomiya en-aut-mei=Shigenobu kn-aut-name=野宮重信 kn-aut-sei=野宮 kn-aut-mei=重信 aut-affil-num=5 ORCID= en-aut-name=SugiyamaNarushi en-aut-sei=Sugiyama en-aut-mei=Narushi kn-aut-name=杉山成史 kn-aut-sei=杉山 kn-aut-mei=成史 aut-affil-num=6 ORCID= en-aut-name=KawamotoTomoaki en-aut-sei=Kawamoto en-aut-mei=Tomoaki kn-aut-name=川本知明 kn-aut-sei=川本 kn-aut-mei=知明 aut-affil-num=7 ORCID= en-aut-name=YamachikaEiki en-aut-sei=Yamachika en-aut-mei=Eiki kn-aut-name=山近英樹 kn-aut-sei=山近 kn-aut-mei=英樹 aut-affil-num=8 ORCID= en-aut-name=UenoTakaaki en-aut-sei=Ueno en-aut-mei=Takaaki kn-aut-name=植野高章 kn-aut-sei=植野 kn-aut-mei=高章 aut-affil-num=9 ORCID= en-aut-name=TakagiShin en-aut-sei=Takagi en-aut-mei=Shin kn-aut-name=高木慎 kn-aut-sei=高木 kn-aut-mei=慎 aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院 口腔外科再建系 affil-num=2 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 耳鼻咽喉・頭頸部外科学 affil-num=3 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 形成再建外科学 affil-num=4 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 耳鼻咽喉・頭頸部外科学 affil-num=5 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 耳鼻咽喉・頭頸部外科学 affil-num=6 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 形成再建外科学 affil-num=7 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 歯顎口腔機能再建外科学 affil-num=8 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 歯顎口腔機能再建外科学 affil-num=9 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 歯顎口腔機能再建外科学 affil-num=10 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 歯顎口腔機能再建外科学 en-keyword=チーム医療 (medical team approach) kn-keyword=チーム医療 (medical team approach) en-keyword=頭頸部癌 (head and neck carcinoma) kn-keyword=頭頸部癌 (head and neck carcinoma) END