Percutaneous ultrasound-guided sclerotherapy with polidocanol microfoam for lymphatic malformations.

Background: Lymphatic malformations (LMs) are low-flow congenital lesions that consist of cysts of varying size. Sclerotherapy with intralesional bleomycin and OK-432 has been reported to yield dramatically beneficial results for this disorder. However, inflammation-related symptoms are often seen after treatment with these sclerosing agents.

Time taken to the maximum increase in the oxygenated hemoglobin level in calf muscle as a predictor of mild and moderate post-thrombotic syndrome.

Background: Near-infrared spectroscopy (NIRS) allows continuous noninvasive monitoring of changes in the tissue levels of oxygenated hemoglobin (O2Hb) and deoxygenated hemoglobin (HHb) and can identify the severity of chronic venous diseases. Here we investigated the predictors of post-thrombotic syndrome (PTS) using NIRS in patients with a first episode of deep venous thrombosis (DVT).

Methods: The study enrolled 129 patients with DVT.

Measurement of calf muscle oxygenation during light-intensity exercise in patients with post-thrombotic syndrome.

Background: Near-infrared spectroscopy (NIRS) provides continuous noninvasive monitoring of changes in the levels of oxygenated hemoglobin (O2Hb) and deoxygenated hemoglobin (HHb) in tissues. The purpose of this study was to investigate changes in calf muscle O2Hb and HHb levels during standing and exercise in the follow-up of deep venous thrombosis (DVT).

Methods: Forty-three patients with a first episode of unilateral proximal DVT were included.

Measurements of calf muscle oxygenation during standing and exercise in patients with primary valvular insufficiency.

Objective: Despite the established role of the calf muscle pump for preventing chronic venous disorders, hemoglobin flow in the calf muscle is poorly understood. Near-infrared spectroscopy (NIRS) provides continuous noninvasive monitoring of changes in tissue-oxygenated hemoglobin (O2Hb) and deoxygenated hemoglobin (HHb) levels. The purpose of this study was to investigate the changes in calf muscle O2Hb and HHb levels during standing and exercise in patients with primary valvular insufficiency (PVI).

Prevalence of various congenital vascular malformations in patients with Klippel-Trenaunay syndrome.

Objective: Klippel-Trenaunay syndrome (KTS) is a condition defined by the association of three physical features: capillary malformation, varicosities, and hypertrophy of bony and soft tissues. However, KTS is characterized by congenital vascular malformations (CVMs) that are difficult to classify. Therefore, the present study was undertaken to analyze the various CVMs in patients with KTS.

The estimation of tissue loss during tangential hydrosurgical debridement.

The preservation of healthy tissue during surgical debridement is desirable as this may improve clinical outcomes. This study has estimated for the first time the amount of tissue lost during debridement using the VERSAJET system of tangential hydrosurgery. A multicenter, prospective case series was carried out on 47 patients with mixed wound types: 21 (45%) burns, 13 (28%) chronic wounds, and 13 (28%) acute wounds.

Administration of a peroxynitrite decomposition catalyst into the bronchial artery attenuates pulmonary dysfunction after smoke inhalation and burn injury in sheep.

Reactive nitrogen species such as peroxynitrite play a significant role in burn and smoke inhalation injury. The bronchial circulation increases more than 10-fold in response to this combination injury. We hypothesized that direct delivery of low-dose WW-85, a peroxynitrite decomposition catalyst, into the bronchial artery would attenuate burn- and smoke inhalation-induced acute lung injury.

Changes in calf muscle deoxygenation after foam sclerotherapy in patients with superficial venous insufficiency.

Objective: This study assessed changes in the calf muscle deoxygenated hemoglobin (HHb) level during light-intensity exercise after ultrasound-guided foam sclerotherapy (UGFS) for superficial venous insufficiency.

Methods: UGFS with 1% or 3% polidocanol foam (POL-F) was used to treat unilateral great saphenous vein reflux in 84 patients. Near-infrared spectroscopy (NIRS) was used to measure calf muscle HHb levels before and 3 months after UGFS.

Deep vein thrombosis after total knee or hip arthroplasty is associated with increased preoperative calf muscle deoxygenation as measured by near-infrared spectroscopy.

Objective: To assess whether the preoperative level of deoxygenated hemoglobin (HHb) in the calf muscle during light-intensity exercise is useful for identifying patients at risk of developing deep vein thrombosis (DVT) after total knee or hip arthroplasty.

Methods: Sixty-eight patients undergoing total knee or total hip arthroplasty were enrolled. The Caprini risk assessment model was used to stratify patients into Caprini 5 to 6, Caprini 7 to 8, and Caprini >8 groups.

Granular cell tumor of the suprasternal space.

A case of granular cell tumor (GCT) was reported. We encountered a 33-year-old woman with a painless, elastic, hard mass in the soft tissue of the suprasternal space. The tumor was excised with several millimeters margin of normal tissue above the deep cervical fascia and the wound was closed primarily.

Fingertip amputation salvage on arterial anastomosis alone: an investigation of its limitations.

Background: We have previously reported the importance of adequate and precise arterial anastomosis and the hypothesis that, up to subzone III, fingertip amputation salvage can be achieved on arterial anastomosis alone. These findings were reported during the meeting of the Japanese Society of Reconstructive Microsurgery. This is our follow-up report with insight and opinion on the limitations of complete fingertip amputation salvage on arterial anastomosis alone.

Sclerosis therapy of bronchial artery attenuates acute lung injury induced by burn and smoke inhalation injury in ovine model.

Introduction: In burned sheep, we showed more than a 10-fold increase in bronchial blood flow following smoke inhalation. It was previously reported that sclerosis of the bronchial artery prior to smoke exposure reduces the pathophysiology of the inhalation insult. We hypothesized that sclerosis of the bronchial artery after insult attenuates smoke/burn-induced acute lung injury.

A novel bronchial artery catheterization technique with preserved blood flow in an ovine model.

The authors devised a novel bronchial artery catheterization technique to deliver agents directly into bronchial circulation with preserved blood flow in an awake ovine model. A polyurethane catheter was inserted into bronchial artery via an incision into the 4th intercostal space. Regional blood flow of the airway was measured by fluorescent microspheres before cannulation, after cannulation, and 7 days after the operative procedure.

Anomalies of the arterial tree that coexist with arteriovenous malformations in the lower extremity.

Several previous reports have documented arteriovenous malformations associated with anomalies of the arterial tree. We report two cases in which a malformation on the foot coexisted with arterial variants of the popliteal artery. Careful therapeutic planning was required to avoid jeopardising perfusion to the distal area.

Combined use of pretest clinical probability score and latex agglutination D-dimer testing for excluding acute deep vein thrombosis.

Objective: Currently, the latex agglutination D-dimer assay is widely used for excluding deep vein thrombosis (DVT) but is considered less sensitive than the enzyme-linked immunosorbent assay-based D-dimer test. The purpose of the present study was to determine if a combination of different cutoff points, rather than a single cutoff point of 1.0 microg/mL, on the latex agglutination D-dimer assay and the pretest clinical probability (PTP) score would be able to reduce the use of venous duplex ultrasound (DU) scanning in patients with suspected DVT.

Magnetic resonance angiography to evaluate septocutaneous perforators in free fibula flap transfer.

Background: In harvesting free fibula composite flaps, preoperative knowledge of the lower limb vascular anatomy is essential to prevent ischaemic complications or flap failure. Magnetic resonance angiography (MRA) allows imaging of the septocutaneous perforators (< or = 1-2mm diameter) of the peroneal artery used in the free fibula flap.

Methods: We investigated seven patients undergoing the free fibula flap preoperatively with high-resolution MRA images to study the following: 1) tibio-peroneal anatomy, 2) peripheral artery disease, 3) the positions of the perforator vessels on the peroneal artery and their course in the posterolateral intermuscular septum and 4) the cutaneous distribution of the perforators, and to compare them to surgical findings.

Inhibition of lung permeability changes after burn and smoke inhalation by an anti-interleukin-8 antibody in sheep.

Purpose: To evaluate the effects of a monoclonal antibody against interleukin-8 (K2.2) on the microvascular fluid flux after combined injury by burn and smoke inhalation.

Methods: Fourteen sheep were prepared surgically by placing a lung lymph catheter and a flank lymph catheter to examine the microvascular fluid flux.

Semi-closed reduction of tripod fractures of zygoma under intraoperative assessment using ultrasonography.

Introduction: We conducted semi-closed reduction of isolated tripod fractures of the zygoma through only a brow incision under intraoperative assessment with ultrasonography.

Methods: Twenty-three patients with unilateral, non-comminuted tripod fractures of zygoma were selected for application of this method at Tokyo Women's Medical University and Tokyo Metropolitan Hiroo General Hospital between April 2002 and April 2006. Patients with orbital floor blowout fractures were excluded.

Effect of ablated bronchial blood flow on survival rate and pulmonary function after burn and smoke inhalation in sheep.

The bronchial circulation plays a significant role in the pathophysiological changes of burn and smoke-inhalation injury. Bronchial blood flow markedly increases immediately after inhalational injury. This study examines whether the ablation of the bronchial artery attenuates pathophysiological changes and improves survival after burn and smoke-inhalational injury in an ovine model.

Treatment of traumatic scars using plasma skin regeneration (PSR) system.

Objectives: Several modalities have been advocated to treat traumatic scars, including surgical techniques and laser resurfacing. Recently, a plasma skin regeneration (PSR) system has been investigated. There are no reports on plasma treatment of traumatic scars.

Hemodynamic alterations in the transferred tissue to lower extremities.

A higher incidence of failure has been reported for free flaps transplanted to the lower extremities. However, the physiological background of this phenomenon has not been elucidated. We reviewed the 3-day postoperative hemodynamic data for 103 free flaps, including the in situ venous pressure (N = 103), arterial pressure (N = 53), and surface blood flow (N = 42).

Randomized, evaluator-blind, split-face comparison study of single cross-linked versus double cross-linked hyaluronic acid in the treatment of glabellar lines.

BACKGROUND At present, various hyaluronic acids are being used to rejuvenate facial skin. There is no comparative study of single cross-linked hyaluronic acid (SCHA) versus double cross-linked hyaluronic acid (DCHA). The objective of our study is to compare the effectiveness and complications of SCHA versus DCHA in the treatment of glabellar lines.