A simple calculation for the preoperative estimation of transverse rectus abdominis myocutaneous free flap volume in 2-stage breast reconstruction using a tissue expander

Kono, Hikaru,Ishii, Naohiro,Takayama, Masayoshi,Takemaru, Masashi,Kishi, Kazuo Korean Society of Plastic and Reconstructive Surge 2018 Archives of Plastic Surgery Vol.45 No.4

Background Flap volume is an important factor for obtaining satisfactory symmetry in breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) free flap. We aimed to develop an easy and simple method to estimate flap volume. Methods We performed a preoperative estimation of the TRAM flap volume in five patients with breast cancer who underwent 2-stage breast reconstruction following an immediate tissue expander operation after a simple mastectomy. We measured the height and width of each flap zone using a ruler and measured the tissue thickness by ultrasound. The volume of each zone, approximated as a triangular or square prism, was then calculated. The zone volumes were summed to obtain the total calculated volume of the TRAM flap. We then determined the width of zone II, so that the calculated flap volume was equal to the required flap volume ($1.2{\times}1.05{\times}$the weight of the resected mastectomy tissue). The TRAM flap was transferred vertically so that zone III was located on the upper side, and zone II was trimmed in the sitting position after vascular anastomosis. We compared the estimated flap width of zone II (=X) with the actual flap width of zone II. Results X was similar to the actual measured width. Accurate volume replacement with the TRAM flap resulted in good symmetry in all cases. Conclusions The volume of a free TRAM flap can be straightforwardly estimated preoperatively using the method presented here, with ultrasound, ruler, and simple calculations, and this technique may help reduced the time required for precise flap tailoring.

Postoperative Loss of Lumbar Lordosis Affects Clinical Outcomes in Patients with Pseudoarthrosis after Posterior Lumbar Interbody Fusion Using Cortical Bone Trajectory Screw Fixation

Yamagishi Akira,Sakaura Hironobu,Ishii Masayoshi,Ohnishi Atsunori,Ohwada Tetsuo 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.3

Study Design: Retrospective cohort study. Purpose: This study aimed to investigate relationships between clinical outcomes and radiographic parameters in patients with pseudoarthrosis after posterior lumbar interbody fusion (PLIF). Overview of Literature: In some patients with pseudoarthrosis after PLIF, clinical symptoms improve following surgery, although pseudoarthrosis can often be one of the complications. However, there are no previous reports describing differences between patients with pseudoarthrosis after PLIF who have obtained better clinical outcomes and those who have not. Methods: Twenty-seven patients who were diagnosed with pseudoarthrosis after single-level PLIF with cortical bone trajectory screw fixation (CBT-PLIF) were enrolled in this study. They were divided into two groups based on mean improvement of 22 points on the Oswestry Disability Index (ODI) at the 2-year follow-up. Group G consisted of 15 patients who showed improvement on the ODI of ≥22 points, and group P consisted of the residual 12 patients. Radiographic parameters, percentage of slip, lumbar lordosis (LL), segmental lordosis, segmental range of motion, screw loosening, and subsidence were compared between the two groups. Results: There were no significant differences between the two groups on radiographic parameters except for postoperative changes in LL. Although surgery-induced changes in LL showed no significant difference between the two groups, changes in LL from before surgery to 2-year follow-up and during postoperative 2-year follow-up were significantly better in group G (mean change of LL: +3.5° and +5.1°, respectively) compared to group P (mean change of LL: −4.6° and −0.5°, respectively) (p<0.01 and 0.05, respectively). Conclusions: Patients with greater improvement in ODI gained LL over the 2-year follow-up, whereas patients with less improvement in ODI lost LL during the 2-year follow-up. These results indicate that there is a significant correlation between clinical outcomes and LL even in patients with pseudoarthrosis after single-level CBT-PLIF.

Calcitonin induces connective tissue growth factor through ERK1/2 signaling in renal tubular cells

Misa Nakamura,Takashi Ozaki,Aiko Ishii,Masayoshi Konishi,Yuji Tsubota,Toru Furui,Hayato Tsuda,Ichiro Mori,Kiichiro Ota,Kennichi Kakudo 생화학분자생물학회 2009 Experimental and molecular medicine Vol.41 No.5

Calcitonin (CT), a polypeptide hormone, plays important roles in a variety of physiological processes. CT has been used clinically to treat osteoporosis and humoral hypercalcemia of malignancy. In order to clarify the pharmacological effects of CT in the kidney, we identified potential downstream genes induced by CT in the renal cells. Using a cDNA subtraction hybridization method, we identified connective tissue growth factor (CTGF) as a CT-induced gene in the porcine renal cell line, LLC-PK1. Furthermore, we found that CT-mediated induction of the gene was not inhibited by cycloheximide, which suggests that CTGF gene was not induced by an increased synthesis of regulating proteins. Therefore, CTGF is an immediate early gene. We further demonstrated that the regulation of CTGF gene expression by CT involved the ERK1/2 pathway, because PD98059, a MEK1 inhibitor, partially inhibited the mRNA expression of CTGF induced by CT. CT-induced CTGF protein expression was also observed in vivo. Our present findings suggest that CT induces the transcription of CTGF through ERK1/2 phosphorylation. We also identified twelve other genes induced by CT that, like CTGF, were related to wound healing. These results suggest that CT may have an effect on renal differentiation and wound healing in the kidney. Calcitonin (CT), a polypeptide hormone, plays important roles in a variety of physiological processes. CT has been used clinically to treat osteoporosis and humoral hypercalcemia of malignancy. In order to clarify the pharmacological effects of CT in the kidney, we identified potential downstream genes induced by CT in the renal cells. Using a cDNA subtraction hybridization method, we identified connective tissue growth factor (CTGF) as a CT-induced gene in the porcine renal cell line, LLC-PK1. Furthermore, we found that CT-mediated induction of the gene was not inhibited by cycloheximide, which suggests that CTGF gene was not induced by an increased synthesis of regulating proteins. Therefore, CTGF is an immediate early gene. We further demonstrated that the regulation of CTGF gene expression by CT involved the ERK1/2 pathway, because PD98059, a MEK1 inhibitor, partially inhibited the mRNA expression of CTGF induced by CT. CT-induced CTGF protein expression was also observed in vivo. Our present findings suggest that CT induces the transcription of CTGF through ERK1/2 phosphorylation. We also identified twelve other genes induced by CT that, like CTGF, were related to wound healing. These results suggest that CT may have an effect on renal differentiation and wound healing in the kidney.

Evidence of the Recent Decade Change in Global Fresh Water Discharge and Evapotranspiration Revealed by Reanalysis and Satellite Observations

서기원,Duane E. Waliser,Baijun Tian,김백민,박성찬,Steve Cocke,손병주,Masayoshi Ishii 한국기상학회 2012 Asia-Pacific Journal of Atmospheric Sciences Vol.48 No.2

Variations of global evapotranspiration (ET) and fresh water discharge from land to oceans (D) are important components of global climate change, but have not been well monitored. In this study, we present an estimate of twenty years (1989 to 2008) variations of global D and ET derived from satellite remote-sensed measurements and recent reanalysis products, ERA-Interim and CFSR, by using a novel application of the water balance equations separately over land and over oceans. Time series of annual mean global D and ET from both satellite observations and reanalyses show clear positive and negative trends, respectively, as a result of modest increase of oceanic evaporation (Eo). The inter-annual variations of D are similar to the in-situ-based observations, and the negative trend of ET supports the previous result that relative humidity has decreased while temperature has increased on land. The results suggest considerable sensitivity of the terrestrial hydrological cycles (e.g., D and ET) to small changes in precipitation and oceanic evaporation.

Pseudocyst of the Scalp

Tsuruta, Daisuke,Hayashi, Akihide,Kobayashi, Hiromi,Nakagawa, Koichi,Furukawa, Masayoshi,Ishii, Masamitsu S. Karger AG 2005 Dermatology Vol.210 No.4

<P>We describe 4 cases of pseudocyst of the scalp, which still is only being described in the Japanese literature. The tumor is characterized as follows: localized between the top and the forehead area of the scalp, it first appears as a solitary reddish, painful small nodule or papule; it then gradually increases in size, protruding into a dome-shaped mass, and becomes associated with alopecia limited to the lesion area. This report describes typical cases of pseudocyst of the scalp, reviews the reported Japanese cases and introduces this tumor to western dermatology.</P><P>Copyright © 2005 S. Karger AG, Basel</P>