JaLCDOI 10.18926/AMO/52013
フルテキストURL 67_6_391.pdf
著者 Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro|
抄録 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.
キーワード polydactyly floating ulnar thumb thumb hypoplasia
Amo Type Case Report
発行日 2013-12
出版物タイトル Acta Medica Okayama
67巻
6号
出版者 Okayama University Medical School
開始ページ 391
終了ページ 395
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 24356724
Web of Sience KeyUT 000328915700008
JaLCDOI 10.18926/AMO/51869
フルテキストURL 67_5_325.pdf
著者 Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro|
抄録 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.
キーワード gender identity disorder sex reassignment surgery (SRS) phalloplasty
Amo Type Case Report
発行日 2013-10
出版物タイトル Acta Medica Okayama
67巻
5号
出版者 Okayama University Medical School
開始ページ 325
終了ページ 331
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 24145733
Web of Sience KeyUT 000325836100007
関連URL http://doi.org/10.18926/AMO/52660
JaLCDOI 10.18926/AMO/51073
フルテキストURL 67_4_271.pdf
著者 Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro|
抄録 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.
キーワード negative pressure wound therapy early exercise therapy wound healing hand surgery
Amo Type Case Report
発行日 2013-08
出版物タイトル Acta Medica Okayama
67巻
4号
出版者 Okayama University Medical School
開始ページ 271
終了ページ 276
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23970327
Web of Sience KeyUT 000323470100010
JaLCDOI 10.18926/AMO/46635
フルテキストURL 65_3_215.pdf
著者 Waseda, Koichi| Tanimoto, Yasushi| Hasegawa, Kenjiro| Miyahara, Nobuaki| Nojima, Daisuke| Ikeda, Genyo| Kanehiro, Arihiko| Okada, Chiharu| Kimata, Yoshihiro| Tanimoto, Mitsune|
抄録 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.
キーワード bronchial asthma Churg-Strauss syndrome eosinophilia necrosis of toe tips stump plasty
Amo Type Case Report
発行日 2011-06
出版物タイトル Acta Medica Okayama
65巻
3号
出版者 Okayama University Medical School
開始ページ 215
終了ページ 218
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2011 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 21709721
Web of Sience KeyUT 000292017500010
JaLCDOI 10.18926/AMO/32875
フルテキストURL fulltext.pdf
著者 Namba, Yuzaburo| Sugiyama, Narushi| Yamashita, Shuji| Hasegawa, Kenjiro| Kimata, Yoshihiro| Ishii, Kazushi| Nasu, Yasutomo|
抄録 <p>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.</p>
キーワード vaginoplasty male-to-female transsexual perineo-scrotal flap
Amo Type Original Article
発行日 2007-12
出版物タイトル Acta Medica Okayama
61巻
6号
出版者 Okayama University Medical School
開始ページ 355
終了ページ 360
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 18183081
Web of Sience KeyUT 000251943800007
JaLCDOI 10.18926/AMO/30981
フルテキストURL fulltext.pdf
著者 Namba, Yuzaburo| Sugiyama, Narushi| Yamashita, Shuji| Tokuyama, Eijiro| Hasegawa, Kenjiro| Kimata, Yoshihiro|
抄録 <p>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.</p>
キーワード gender identity disorder sex reassignment surgery phantom erectile penis
Amo Type Case Report
発行日 2008-06
出版物タイトル Acta Medica Okayama
62巻
3号
出版者 Okayama University Medical School
開始ページ 213
終了ページ 216
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 18596839
Web of Sience KeyUT 000257130300010
JaLCDOI 10.18926/AMO/30948
フルテキストURL fulltext.pdf
著者 Namba, Yuzaburo| Sugiyama, Narushi| Yamashita, Shuji| Hasegawa, Kenjiro| Kimata, Yoshihiro| Nakatsuka, Mikiya|
抄録 <p>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.</p>
キーワード vaginoplasty intersexual pudendal-thigh flap
Amo Type Case Report
発行日 2008-12
出版物タイトル Acta Medica Okayama
62巻
6号
出版者 Okayama University Medical School
開始ページ 415
終了ページ 419
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
Web of Sience KeyUT 000262025000009