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Sujino K, Tanese K, Saito Y, Kuramoto J, Iwazaki H, Ida T, Aiso S, Imanishi N, Kajita H, Fukuda K, Amagai M, Tanikawa A. Visualization of intradermal blood vessel structures by dual-wavelength photoacoustic microscopy and characterization of three-dimensional construction of livedo-racemosa in cutaneous polyarteritis nodosa. J Dermatol Sci 2024; 114:71-78. [PMID: 38644095 DOI: 10.1016/j.jdermsci.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/26/2024] [Accepted: 03/21/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Photoacoustic microscopy is expected to have clinical applications as a noninvasive and three-dimensional (3D) method of observing intradermal structures. OBJECTIVE Investigate the applicability of a photoacoustic microscope equipped with two types of pulsed lasers that can simultaneously recognize hemoglobin and melanin. METHODS 16 skin lesions including erythema, pigmented lesions, vitiligo and purpura, were analyzed to visualize 3D structure of melanin granule distribution and dermal blood vessels. 13 cases of livedo racemosa in cutaneous polyarteritis nodosa (cPN) were further analyzed to visualize the 3D structure of dermal blood vessels in detail. Vascular structure was also analyzed in the biopsy specimens obtained from tender indurated erythema of cPN by CD34 immunostaining. RESULTS Hemoglobin-recognition signal clearly visualized the 3D structure of dermal blood vessels and melanin-recognition signal was consistently reduced in vitiligo. In livedo racemosa, the hemoglobin-recognition signal revealed a relatively thick and large reticular structure in the deeper layers that became denser and finer toward the upper layers. The numerical analysis revealed that the number of dermal blood vessels was 1.29-fold higher (p<0.05) in the deeper region of the lesion than that of normal skin. The CD34 immunohistochemical analysis in tender indurated erythema revealed an increased number of dermal vessels compared with normal skin in 88.9% (8/9) of the cases, suggesting that vascular network remodeling had occurred in cPN. CONCLUSION The photoacoustic system has an advantage in noninvasively detecting dermal blood vessel structures that are difficult to recognize by two-dimensional histopathology specimen examination and is worth evaluating in various skin diseases.
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Affiliation(s)
- Kazuyo Sujino
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Keiji Tanese
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
| | - Yasuko Saito
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Junko Kuramoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | | | | | - Sadakazu Aiso
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kajita
- Department of Plastic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keitaro Fukuda
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Tanikawa
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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Takaya K, Sakamoto Y, Noji S, Imanishi N, Kishi K. Three-dimensional adipofascial and dermal structures involved in forehead crease formation. Clin Anat 2024; 37:321-328. [PMID: 37732501 DOI: 10.1002/ca.24118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/26/2023] [Indexed: 09/22/2023]
Abstract
Deeply etched forehead creases indicate aging. Various treatments such as filler injections, fat grafting, and facelift surgery are used to remove them. However, knowledge of the anatomical structures associated with subcutaneous tissue changes and the superficial musculoaponeurotic system is lacking, and there is no consensus about the appropriate treatment. We have investigated the subcutaneous structures involved in forehead creases; this will help to establish selection criteria for improved treatment. The forehead sections of five unfixed adult Asian cadavers were obtained. Tissues containing forehead creases were removed from the periosteum and were examined using gross observation, radiography, histology, and nano-computed tomography. All methods revealed that the dermis in the skin crease area, namely the fold visible from the body surface, was bound to the frontalis muscle by a three-dimensional fibrous structure between the fatty septa. This structure was dense near the skin folds and sparse and thin in other areas. In particular, it was tightly bound to the dermis immediately below the crease, with collagen fibers traversing toward the epidermis. In addition, there were fewer skin appendages near the crease than in the normal area, or they were absent altogether; the epidermis was thicker, and the dermal papillae were more developed. It is thought that the density and firmness of the fibrous fatty septal structures between the dermis-frontalis muscle and the specific structures of the epidermis and dermis immediately below the crease account for the characteristic plastic forehead creases.
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Affiliation(s)
- Kento Takaya
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiaki Sakamoto
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shinobu Noji
- Laboratory of Cell and Tissue Biology, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Suzuki Y, Kajita H, Watanabe S, Otaki M, Okabe K, Sakuma H, Imanishi N, Kishi K. Preoperative photoacoustic versus indocyanine green lymphography in lymphaticovenular anastomosis outcomes for lower extremity lymphedema: A pilot study. Microsurgery 2024; 44:e31153. [PMID: 38376254 DOI: 10.1002/micr.31153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 12/22/2023] [Accepted: 02/01/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Identification of the proper lymphatics is important for successful lymphaticovenular anastomosis (LVA) for lymphedema; however, visualization of lymphatic vessels is challenging. Photoacoustic lymphangiography (PAL) can help visualize lymphatics more clearly than other modalities. Therefore, we investigated the usefulness of PAL and determined whether the clear and three-dimensional image of PAL affects LVA outcomes. METHODS We recruited 22 female patients with lower extremity lymphedema. The operative time, number of incisions, number of anastomoses, lymphatic vessel detection rate (number of functional lymphatics identified during the operation/number of incisions), and limb volume changes preoperatively and 3 months postoperatively were compared retrospectively. The patients were divided according to whether PAL was performed or not, and results were compared between those undergoing PAL (PAL group; n = 10) and those who did not (near-infrared fluorescence [NIRF] group, n = 12). RESULTS The mean age of the patients was 55.9 ± 15.1 years in the PAL group and 50.7 ± 14.9 years in the NIRF group. One patient in the PAL group and three in the NIRF group had primary lymphedema. Eighteen patients (PAL group, nine; and NIRF group, nine) had secondary lymphedema. Based on preoperative evaluation using the International Society of Lymphology (ISL) classification, eight patients were determined to be in stage 2 and two patients in late stage 2 in the PAL group. In contrast, in the NIRF group, one patient was determined to be in stage 0, three patients each in stage 1 and stage 2, and five patients in late stage 2. Lymphatic vessel detection rates were 93% (42 LVAs and 45 incisions) and 83% (50 LVAs and 60 incisions) in the groups with and without PAL, respectively (p = 0.42). Limb volume change was evaluated in five limbs of four patients and in seven limbs of five patients in the PAL and NIRF groups as 336.6 ± 203.6 mL (5.90% ± 3.27%) and 52.9 ± 260.7 mL (0.71% ± 4.27%), respectively. The PAL group showed a significant volume reduction. (p = .038). CONCLUSIONS Detection of functional lymphatic vessels on PAL is useful for treating LVA.
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Affiliation(s)
- Yushi Suzuki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shiho Watanabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Marika Otaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Okabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hisashi Sakuma
- Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Liao W, Subpa-Asa A, Asano Y, Zheng Y, Kajita H, Imanishi N, Yagi T, Aiso S, Kishi K, Sato I. Reliability-Aware Restoration Framework for 4D Spectral Photoacoustic Data. IEEE Trans Pattern Anal Mach Intell 2023; 45:15445-15461. [PMID: 37651493 DOI: 10.1109/tpami.2023.3310981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Spectral photoacoustic imaging (PAI) is a new technology that is able to provide 3D geometric structure associated with 1D wavelength-dependent absorption information of the interior of a target in a non-invasive manner. It has potentially broad applications in clinical and medical diagnosis. Unfortunately, the usability of spectral PAI is severely affected by a time-consuming data scanning process and complex noise. Therefore in this study, we propose a reliability-aware restoration framework to recover clean 4D data from incomplete and noisy observations. To the best of our knowledge, this is the first attempt for the 4D spectral PA data restoration problem that solves data completion and denoising simultaneously. We first present a sequence of analyses, including modeling of data reliability in the depth and spectral domains, developing an adaptive correlation graph, and analyzing local patch orientation. On the basis of these analyses, we explore global sparsity and local self-similarity for restoration. We demonstrated the effectiveness of our proposed approach through experiments on real data captured from patients, where our approach outperformed the state-of-the-art methods in both objective evaluation and subjective assessment.
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Takatsume Y, Nakase J, Oshima T, Kanayama T, Imanishi N, Tsuchiya H. Development of an educational three-dimensional anatomical structure replication tool and its application to medial open-wedge high tibial osteotomy. Knee 2023; 44:150-157. [PMID: 37672905 DOI: 10.1016/j.knee.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/23/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND With the standardization of surgical techniques and continuous development of plate fixators, medial open-wedge high tibial osteotomy (OWHTO) has become an option for the treatment of medial knee osteoarthritis. However, it is also associated with several complications. To reduce the risk of these complications, it is essential for surgeons to accurately understand the three-dimensional (3D) anatomical structures, including the surroundings of the surgical field. Gross dissection using a cadaver provides a large surgical field and is the best learning method for studying anatomical structures in three dimensions; however, it is not available at all medical institutions. METHODS One female cadaveric knee, fixed using the Thiel method, was used in this study, and OWHTO was performed. A series of photographs was taken from approximately 60 different angles at each stage of the autopsy for digital photogrammetry to ensure that there was at least a 60% overlap between photographs. RESULTS Each 3D object was created to be faithful to the original specimen and displayed on an augmented reality headset. It was created to capture the subtle nuances of irregular shapes and structures, highlighting the unique ability of photogrammetry to capture pathology. This method allows surgeons to visualize the location of neurovascular injuries in the intraoperative field of view. CONCLUSIONS Using a technique that applies digital photogrammetry to create 3D objects from handheld photographs, this reports for the first time an educational tool that can reproduce the anatomy related to high tibial osteotomy in three dimensions.
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Affiliation(s)
| | - Junsuke Nakase
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
| | - Takeshi Oshima
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; Asanogawa General Hospital, Kanazawa, Japan
| | - Tomoyuki Kanayama
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Takatsume Y, Kajita H, Imanishi N. A technique for decreasing reflection during cadaveric photography. Clin Anat 2023; 36:946-950. [PMID: 37227076 DOI: 10.1002/ca.24073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 05/26/2023]
Abstract
To create anatomical educational materials that can be viewed in three dimensions using stereo photographs and photogrammetry, multiple photographs must be taken from different directions. In this process, shadows and reflections from different positions in each photograph are undesirable for creating three-dimensional (3D) anatomy educational materials. Although a ring flash eliminates shadows, allowing light to enter from all directions, reflections cannot be eliminated. In particular, Thiel-embalmed cadavers, which are widely used in clinical anatomy, are highly wet and exhibit strong specular highlights. In this study, a straight polarization filter was attached to a handheld camera lens and ring flash, and shooting was performed using cross-polarization photography. Consequently, even in Thiel-embalmed cadavers, the details lost due to the effects of reflections and shadows can be recovered, and good results can be obtained when taking stereo photos or creating a 3D model using photogrammetry.
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Affiliation(s)
| | - Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
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Suzuki Y, Kajita H, Urano M, Watanabe S, Otaki M, Takatsume Y, Sakuma H, Imanishi N, Kishi K. Measurement of lymphatic vessel depth using photoacoustic imaging. Lasers Surg Med 2023; 55:164-168. [PMID: 36584080 DOI: 10.1002/lsm.23629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/16/2022] [Accepted: 12/17/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Information regarding the depth of lymphatic vessel is important for lymphatic surgeons because rapid identification of functional lymphatic vessels and veins is necessary to perform good lymphaticovenular anastomosis, which is a surgical procedure for lymphedema cases. Photoacoustic lymphangiography (PAL) may be useful for such identification because it allows the assessment of the depth of lymphatic vessels. Thus, we aimed to measure the lymphatic vessel depth using images obtained by PAL. METHODS This study included healthy individuals and patients with lymphedema. In all participants, indocyanine green dissolved in dextrose was injected subcutaneously into the first and fourth webs of the foot and the lateral malleolus, and PAL was performed on the medial side of the lower leg. The lymphatic vessel depth was measured from the ankle joint, 10 cm above the medial malleolus, and 20 cm above the medial malleolus on PAL in the cross-sectional view and was compared between the participant groups. RESULTS The healthy group (mean age, 43.3 ± 12.9 years) included 21 limbs of 4 male and 16 female healthy individuals (bilateral limbs of 1 patient were considered). The lymphedema group (mean age, 62.0 ± 11.7 years) included 17 limbs of 3 male and 14 female patients with lymphedema. The average lymphatic vessel depths from the ankle joint, 10 cm above the medial malleolus, and 20 cm above the medial malleolus were 2.6, 4.7, and 5.6 mm in the healthy group and 3.6, 7.3, and 7.4 mm in the lymphedema group, respectively. Lymphatic vessels were significantly deeper in the lymphedema group than in the healthy group at all measurement locations. CONCLUSIONS Using PAL, we determined the lymphatic vessel depth in living bodies. By searching for the lymphatic vessels based on our findings, even surgeons who are relatively inexperienced with lymphatic surgery may be able to identify functional lymphatic vessels more efficiently.
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Affiliation(s)
- Yushi Suzuki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Moemi Urano
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Shiho Watanabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Marika Otaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | - Hisashi Sakuma
- Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Nakano Y, Abe Y, Kitago M, Yagi H, Hasegawa Y, Hori S, Koizumi W, Ojima H, Imanishi N, Kitagawa Y. Extrahepatic approach for taping the common trunk of the middle and left hepatic veins or the left hepatic vein alone in laparoscopic hepatectomy (with videos). J Hepatobiliary Pancreat Sci 2023; 30:192-201. [PMID: 35767184 DOI: 10.1002/jhbp.1212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/02/2022] [Accepted: 06/24/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Outflow control is difficult, and techniques required for effectively handling intraoperative hemorrhage during laparoscopic hepatectomy have not previously been adequately reported. METHODS Sixteen patients underwent surgery, of which 15 underwent laparoscopic left hepatectomy and one underwent laparoscopic partial hepatectomy of the caudate lobe. Encircling and taping of the common trunk of the middle (MHV) and left hepatic veins (LHV) was performed in 12 patients, and that of the LHV alone in four patients. Surgical techniques based on anatomical landmarks and histological findings are presented with videos. Histological confirmation of the anatomical landmarks for these procedures was performed in fresh cadavers to understand the anatomical structures and layers involved. RESULTS The median procedure duration was 15 (6-25) minutes. All procedures were performed safely with no major bleeding. Histological findings showed fibrous connective tissue between the tunica adventitia of the inferior vena cava (IVC) and the Laennec's capsule of the liver. The layer of dissection was along the tunica adventitia of the IVC. CONCLUSIONS The surgical techniques for encircling and taping of the common trunk of the MHV and LHV and the LHV alone based on anatomical landmarks were feasible and could allow for efficient outflow control in laparoscopic hepatectomy.
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Affiliation(s)
- Yutaka Nakano
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Yagi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yasushi Hasegawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shutaro Hori
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Wataru Koizumi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hidenori Ojima
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Watanabe S, Kajita H, Suzuki Y, Urano M, Otaki M, Sakuma H, Imanishi N, Tsuji T, Jinzaki M, Kishi K. Photoacoustic lymphangiography is a possible alternative for lymphedema staging. J Vasc Surg Venous Lymphat Disord 2022; 10:1318-1324.e2. [PMID: 35995329 DOI: 10.1016/j.jvsv.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/08/2022] [Accepted: 07/18/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Photoacoustic imaging is a new technique that uses the photoacoustic effect. In photoacoustic lymphangiography (PAL), images of the lymphatic vessels can be visualized using light-absorbing contrast agents. In the present study, we investigated the efficacy of PAL for lymphedema staging. METHODS We performed PAL of the lower extremities and examined the clinical implications of using PAL for staging lymphedema by comparing the PAL images with those obtained using lymphoscintigraphy. Of 47 patients with lymphedema who had been outpatients or hospitalized at our institution between May 2018 and September 2020 and had undergone PAL, 15 with 18 limbs who had also undergone lymphoscintigraphy were included in the present study. The lymphoscintigraphy findings were classified using the Maegawa classification. We also investigated whether PAL could clearly visualize the lymphatic vessels and concisely reflect the disease state by counting the number of lymphatic vessels observed using PAL. RESULTS The PAL findings were categorized into three groups: collecting lymphatic vessels, dermal backflow (DBF), and no lymphatic vessels. The collecting lymphatic vessels group corresponded to types 2 and 3 in the Maegawa classification; DBF corresponded to types 3 and 4, and the no lymphatic vessels group corresponded to type 4. The number of lymphatic vessels visualized using PAL was similar to that with lymphoscintigraphy. As the disease progressed, the number of lymphatic vessels observed decreased, increased DBF was detected, and, eventually, the lymphatic vessels were not visible, corresponding to the general changes observed via lymphoscintigraphy with stage progression. CONCLUSIONS The findings from PAL and lymphoscintigraphy tended to correspond, suggesting that PAL could be useful for lymphedema staging.
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Affiliation(s)
- Shiho Watanabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yushi Suzuki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Moemi Urano
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Marika Otaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hisashi Sakuma
- Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Tamainato S, Mori D, Takeda Y, Yamamoto O, Imanishi N. Composite Polymer Electrolytes for Lithium Batteries. ChemistrySelect 2022. [DOI: 10.1002/slct.202201667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Tamainato
- Graduate School of Enigineering Mie University Tsu 514-8507 Japan
| | - D. Mori
- Graduate School of Enigineering Mie University Tsu 514-8507 Japan
| | - Y. Takeda
- Graduate School of Enigineering Mie University Tsu 514-8507 Japan
| | - O. Yamamoto
- Graduate School of Enigineering Mie University Tsu 514-8507 Japan
| | - N. Imanishi
- Graduate School of Enigineering Mie University Tsu 514-8507 Japan
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Abstract
In lower abdominal flap representing transverse rectus abdominis musculocutaneous (TRAM) flap or deep inferior epigastric perforator (DIEP) flap, superficial inferior epigastric vein (SIEV) exists as superficial and independent venous system from deep system. The superficial venous drainage is dominant despite a dominant deep arterial supply in anterior abdominal wall. As TRAM or DIEP flaps began to be widely used for breast reconstruction, venous congestion issue has been arisen. Many clinical series in regard to venous congestion despite patent microvascular anastomosis site were reported. Venous congestion could be divided in two conditions by the area of venous congestion and each condition is from different anatomical causes. First, if venous congestion was shown in whole flap, it is due to the connection between SIEV and vena comitantes of DIEP. Second, if venous congestion is limited in above midline (Hartrampf zone II), it is due to problem in venous midline crossover. In this article, the authors reviewed the role of SIEV in lower abdominal flap based on the various anatomic and clinical studies. The contents are mainly categorized into four main issues; basic anatomy of SIEV, the two cause of venous congestion, connection between SIEV and vena comitantes of DIEP, and midline crossover of SIEV.
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Affiliation(s)
- Seong Oh Park
- Department of Plastic and Reconstructive Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University College of Medicine, Tokyo, Japan
| | - Hak Chang
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
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Negishi T, Nozaki S, Ito K, Seki H, Hosoda K, Nagura T, Imanishi N, Jinzaki M, Ogihara N. Three-Dimensional Innate Mobility of the Human Foot on Coronally-Wedged Surfaces Using a Biplane X-Ray Fluoroscopy. Front Bioeng Biotechnol 2022; 10:800572. [PMID: 35186902 PMCID: PMC8854865 DOI: 10.3389/fbioe.2022.800572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Improving our understanding on how the foot and ankle joints kinematically adapt to coronally wedged surfaces is important for clarifying the pathogenetic mechanism and possible interventions for the treatment and prevention of foot and lower leg injuries. It is also crucial to interpret the basic biomechanics and functions of the human foot that evolved as an adaptation to obligatory bipedal locomotion. Therefore, we investigated the three-dimensional (3D) bone kinematics of human cadaver feet on level (0°, LS), medially wedged (−10°, MWS), and laterally wedged (+10°, LWS) surfaces under axial loading using a biplanar X-ray fluoroscopy system. Five healthy cadaver feet were axially loaded up to 60 kg (588N) and biplanar fluoroscopic images of the foot and ankle were acquired during axial loading. For the 3D visualization and quantification of detailed foot bony movements, a model-based registration method was employed. The results indicated that the human foot was more largely deformed from the natural posture when the foot was placed on the MWS than on the LWS. During the process of human evolution, the human foot may have retained the ability to more flexibly invert as in African apes to better conform to MWS, possibly because this ability was more adaptive even for terrestrial locomotion on uneven terrains. Moreover, the talus and tibia were externally rotated when the foot was placed on the MWS due to the inversion of the calcaneus, and they were internally rotated when the foot was placed on the LWS due to the eversion of the calcaneus, owing to the structurally embedded mobility of the human talocalcaneal joint. Deformation of the foot during axial loading was relatively smaller on the MWS due to restricted eversion of the calcaneus. The present study provided new insights about kinematic adaptation of the human foot to coronally wedged surfaces that is inherently embedded and prescribed in its anatomical structure. Such detailed descriptions may increase our understanding of the pathogenetic mechanism and possible interventions for the treatment and prevention of foot and lower leg injuries, as well as the evolution of the human foot.
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Affiliation(s)
- Takuo Negishi
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
- *Correspondence: Takuo Negishi, ; Naomichi Ogihara,
| | - Shuhei Nozaki
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Kohta Ito
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Hiroyuki Seki
- Department of Orthopedic Surgery, Ogikubo Hospital, Tokyo, Japan
| | - Koh Hosoda
- Graduate School of Engineering Science, Osaka University, Suita, Japan
| | - Takeo Nagura
- Department of Clinical Biomechanics, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
- *Correspondence: Takuo Negishi, ; Naomichi Ogihara,
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Suzuki Y, Kajita H, Watanabe S, Otaki M, Okabe K, Sakuma H, Takatsume Y, Imanishi N, Aiso S, Kishi K. Surgical Applications of Lymphatic Vessel Visualization Using Photoacoustic Imaging and Augmented Reality. J Clin Med 2021; 11:jcm11010194. [PMID: 35011933 PMCID: PMC8745664 DOI: 10.3390/jcm11010194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/12/2021] [Accepted: 12/26/2021] [Indexed: 11/16/2022] Open
Abstract
Lymphaticovenular anastomosis (LVA) is a widely performed surgical procedure for the treatment of lymphedema. For good LVA outcomes, identifying lymphatic vessels and venules is crucial. Photoacoustic lymphangiography (PAL) is a new technology for visualizing lymphatic vessels. It can depict lymphatic vessels at high resolution; therefore, this study focused on how to apply PAL for lymphatic surgery. To visualize lymphatic vessels, indocyanine green was injected as a color agent. PAI-05 was used as the photoacoustic imaging device. Lymphatic vessels and veins were visualized at 797- and 835-nm wavelengths. First, it was confirmed whether the branching of the vasculature as depicted by the PAL was consistent with the actual branching of the vasculature as confirmed intraoperatively. Second, to use PAL images for surgical planning, preoperative photoacoustic images were superimposed onto the patient limb through augmented reality (AR) glasses (MOVERIO Smart Glass BT-30E). Lymphatics and venule markings drawn using AR glasses were consistent with the actual intraoperative images obtained during LVA. To anastomose multiple lymphatic vessels, a site with abundant venous branching was selected as the incision site; and selecting the incision site became easier. The anatomical morphology obtained by PAL matched the surgical field. AR-based marking could be very useful in future LVA.
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Affiliation(s)
- Yushi Suzuki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (H.K.); (S.W.); (M.O.); (K.O.); (K.K.)
- Correspondence: ; Tel.: +81-3-5363-3814
| | - Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (H.K.); (S.W.); (M.O.); (K.O.); (K.K.)
| | - Shiho Watanabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (H.K.); (S.W.); (M.O.); (K.O.); (K.K.)
| | - Marika Otaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (H.K.); (S.W.); (M.O.); (K.O.); (K.K.)
| | - Keisuke Okabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (H.K.); (S.W.); (M.O.); (K.O.); (K.K.)
| | - Hisashi Sakuma
- Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba 272-8513, Japan;
| | - Yoshifumi Takatsume
- Department of Anatomy, Keio University School of Medicine, Tokyo 160-8582, Japan; (Y.T.); (N.I.)
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo 160-8582, Japan; (Y.T.); (N.I.)
| | | | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (H.K.); (S.W.); (M.O.); (K.O.); (K.K.)
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Suzuki Y, Kajita H, Watanabe S, Okabe K, Sakuma H, Imanishi N, Aiso S, Kishi K. Application of Photoacoustic Imaging for Lymphedema Treatment. J Reconstr Microsurg 2021; 38:254-262. [PMID: 34959248 PMCID: PMC8904143 DOI: 10.1055/s-0041-1736518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background
Lymphatic vessels are difficult to identify using existing modalities as because of their small diameter and the transparency of the lymph fluid flowing through them.
Methods
Here, we introduce photoacoustic lymphangiography (PAL), a new modality widely used for lymphedema treatment, to observe limb lymphatic vessels. The photoacoustic imaging system used in this study can simultaneously visualize lymphatic vessels and veins with a high resolution (0.2 mm) and can also observe their three-dimensional relationship with each other.
Results
High-resolution images of the lymphatic vessels, detailed structure of the dermal back flow, and the three-dimensional positional relationship between the lymphatic vessels and veins were observed by PAL.
Conclusion
The clear image provided by PAL could have a major application in pre- and postoperative use during lymphaticovenular anastomosis for lymphedema treatment.
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Affiliation(s)
- Yushi Suzuki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shiho Watanabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Okabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hisashi Sakuma
- Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Sadakazu Aiso
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan.,Luxonus Inc. Kawasaki, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Kikkawa R, Kajita H, Imanishi N, Aiso S, Bise R. Unsupervised Body Hair Detection by Positive-Unlabeled Learning in Photoacoustic Image. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:3349-3352. [PMID: 34891957 DOI: 10.1109/embc46164.2021.9630720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Photoacoustic (PA) imaging is a new imaging technology that can non-invasively visualize blood vessels and body hair in 3D. It is useful in cosmetic surgery for detecting body hair and computing metrics such as the number and thicknesses of hairs. Previous supervised body hair detection methods often do not work if the imaging conditions change from training data. We propose an unsupervised hair detection method. Hair samples were automatically extracted from unlabeled samples using prior knowledge about spatial structure. If hair (positive) samples and unlabeled samples are obtained, Positive Unlabeled (PU) learning becomes possible. PU methods can learn a binary classifier from positive samples and unlabeled samples. The advantage of the proposed method is that it can estimate an appropriate decision boundary in accordance with the distribution of the test data. Experimental results using real PA data demonstrate that the proposed approach effectively detects body hairs.
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Negishi T, Ito K, Hosoda K, Nagura T, Ota T, Imanishi N, Jinzaki M, Oishi M, Ogihara N. Comparative radiographic analysis of three-dimensional innate mobility of the foot bones under axial loading of humans and African great apes. R Soc Open Sci 2021; 8:211344. [PMID: 34804579 PMCID: PMC8596007 DOI: 10.1098/rsos.211344] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/21/2021] [Indexed: 05/13/2023]
Abstract
The human foot is considered to be morphologically adapted for habitual bipedal locomotion. However, how the mobility and mechanical interaction of the human foot with the ground under a weight-bearing condition differ from those of African great apes is not well understood. We compared three-dimensional (3D) bone kinematics of cadaver feet under axial loading of humans and African great apes using a biplanar X-ray fluoroscopy system. The calcaneus was everted and the talus and tibia were internally rotated in the human foot, but such coupling motion was much smaller in the feet of African great apes, possibly due to the difference in morphology of the foot bones and articular surfaces. This study also found that the changes in the length of the longitudinal arch were larger in the human foot than in the feet of chimpanzees and gorillas, indicating that the human foot is more deformable, possibly to allow storage and release of the elastic energy during locomotion. The coupling motion of the calcaneus and the tibia, and the larger capacity to be flattened due to axial loading observed in the human foot are possibly morphological adaptations for habitual bipedal locomotion that has evolved in the human lineage.
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Affiliation(s)
- Takuo Negishi
- Department of Biological Science, Graduate School of Science, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kohta Ito
- Graduate School of Human Sciences, Osaka University, Suita, Osaka Japan
| | - Koh Hosoda
- Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
| | - Takeo Nagura
- School of Medicine, Keio University, Tokyo, Japan
| | - Tomohiko Ota
- School of Medicine, Keio University, Tokyo, Japan
| | | | | | - Motoharu Oishi
- School of Veterinary Medicine, Azabu University, Sagamihara, Japan
| | - Naomichi Ogihara
- Department of Biological Science, Graduate School of Science, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Suzuki Y, Kajita H, Oh A, Urano M, Watanabe S, Sakuma H, Imanishi N, Tsuji T, Jinzaki M, Kishi K. Photoacoustic lymphangiography exhibits advantages over near-infrared fluorescence lymphangiography as a diagnostic tool in patients with lymphedema. J Vasc Surg Venous Lymphat Disord 2021; 10:454-462.e1. [PMID: 34352419 DOI: 10.1016/j.jvsv.2021.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/22/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Photoacoustic imaging (PAI) is a new technique that can evaluate the vascular system using photoacoustic effects. The present study compared the ability of the new photoacoustic lymphangiography (PAL) method and more standard near-infrared fluorescence (NIRF) to image the lymphatic system in patients with secondary lymphedema following gynecological cancer surgery. METHODS Patients with secondary lymphedema in the lower extremities following gynecologic cancer surgery, who were assessed using PAL between May 2018 and January 2019 were recruited. NIRF was performed first using 5.0 mg/mL of indocyanine green injected using a 0.2-cc 30-gauge needle. Correlations between NIRF and PAL findings on patient images were subsequently examined. RESULTS Seventeen patients with secondary lymphedema were enrolled. The mean age of the patients was 61 ± 11 years. The imaging sites were the medial lower leg in 15 patients, the posterior lower leg in nine patients, the lateral lower leg in seven patients, the medial knee in four patients, and other areas in three patients. A total of 38 pictures were obtained. Five distinct lymphatic patterns were observed over the entire sample using PAL: straight, winding, spiderweb, nebulous, and black-out pattern Eighteen of the 24 limbs (75%) that exhibited a linear pattern in NIRF exhibited a straight pattern in PAL, and 19 of the 20 limbs (95%) that exhibited a splash pattern in NIRF exhibited a winding or spider web pattern in PAL. Eight limbs exhibiting diffuse patterns without linear or splash patterns with NIRF were all nebulous or black-out patterns in PAL. This suggests that more severe lymphatic degeneration was associated with poorer visualization in PAL. CONCLUSIONS NIRF plays an important role in lymphedema treatment. In the present study, various PAL patterns were compared with those observed using NIRF. PAL provided clearer images including transectional views, which were not available using NIRF, and may promote further understanding of the changes in the lymphatic structure and function in patients with secondary lymphedema.
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Affiliation(s)
- Yushi Suzuki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Anna Oh
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Moemi Urano
- Department of Anatomy, Keio University School of Medicine
| | - Shiho Watanabe
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hisashi Sakuma
- Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | | | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Nakahara T, Yamada M, Yokoyama Y, Yamada Y, Narita K, Imanishi N, Yamazaki M, Shimizu H, Narula J, Jinzaki M. Saphenous vein valve assessment utilizing upright CT to potentially improve graft assessment for bypass surgery. Sci Rep 2021; 11:11602. [PMID: 34078949 PMCID: PMC8172633 DOI: 10.1038/s41598-021-90998-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/04/2021] [Indexed: 11/09/2022] Open
Abstract
Saphenous veins (SVs) are frequently employed as bypass grafts. The SV graft failure is predominantly seen at the valve site. Avoiding valves during vein harvest would help reduce graft failure. We endeavored to detect SV valves, tributaries, and vessel size employing upright computed tomography (CT) for the raw cadaver venous samples and in healthy volunteers. Five cadaver legs were scanned. Anatomical analysis showed 3.0 (IQR: 2.0-3.0) valves and 13.50 (IQR: 10.00-16.25) tributaries. The upright CT completely detected, compared to 2.0 (IQR: 1.5-2.5, p = 0.06) valves and 9.5 (IQR: 7.5-13.0, p = 0.13) tributaries by supine CT. From a total of 190 volunteers, 138 (men:75, women:63) were included. The number of valves from the SF junction to 35 cm were significantly higher in upright CT than in supine CT bilaterally [upright vs. supine, Right: 4 (IQR: 3-5) vs. 2 (IQR:1-2), p < 0.0001, Left: 4 (IQR: 3-5) vs. 2 (IQR: 1-2), p < 0.0001]. The number of tributaries and vessel areas per leg were also higher for upright compared with supine CT. Upright CT enables non-invasive detection of SV valves, tributaries, and vessel size. Although not tested here, it is expected that upright CT may potentially improve graft assessment for bypass surgery.
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Affiliation(s)
- Takehiro Nakahara
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Minoru Yamada
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Yoichi Yokoyama
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Keiichi Narita
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan
| | - Nobuaki Imanishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masataka Yamazaki
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Shimizu
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Jagat Narula
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku, Tokyo, 160-8582, Japan.
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19
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Suzuki Y, Kajita H, Oh A, Takemaru M, Sakuma H, Tsuji T, Imanishi N, Aiso S, Kishi K. Use of photoacoustic imaging to determine the effects of aging on lower extremity lymphatic vessel function. J Vasc Surg Venous Lymphat Disord 2021; 10:125-130. [PMID: 34020108 DOI: 10.1016/j.jvsv.2021.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Aging is one of the causes of primary lymphedema. However, the effects of aging on the lymphatic system are still not completely understood. We investigated the effects of aging on the lymphatic vessels in the lower extremities of healthy volunteers using photoacoustic imaging. METHODS Healthy volunteers who underwent photoacoustic lymphangiography between March 2018 and January 2019 were enrolled. To visualize lymphatics, indocyanine green (ICG, 5.0 mg/mL) was injected subcutaneously into the first and fourth web spaces of the foot and under the lateral malleolus. Subsequently, near-infrared fluorescence lymphography was performed to confirm good ICG flow, and photoacoustic lymphangiography was performed on the medial side of the lower leg. Neodymium-doped yttrium aluminum garnet laser irradiation at 797 and 835 nm, the optimal wavelengths for visualizing ICG and blood, was applied. The number of lymphatic vessels shown at areas 10 cm (L10) and 20 cm (L20) cranially from the internal malleolus was counted. RESULTS Nineteen healthy volunteers (4 males and 15 females) were enrolled in the study. Their mean age was 42.9 ± 12.8 years. One volunteer was bilaterally imaged; 15 left lower limbs and 5 right lower limbs were imaged. The number of lymphatic vessels visualized increased with age. There were strong positive correlations between age and L10 (R = 0.729, P < .001) and between age and L20 (R = 0.570, P = .009). CONCLUSIONS Photoacoustic imaging indicates that the number of lymphatic vessels increases with age. Lymphatic stasis resulted in visualization of not only normal drainage pathways but also nonfunctional lymphatic pathways.
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Affiliation(s)
- Yushi Suzuki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Anna Oh
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masashi Takemaru
- Department of Plastic and Reconstructive Surgery, Yokohama Municipal Citizen Hospital, Kanagawa, Japan
| | - Hisashi Sakuma
- Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Sadakazu Aiso
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan; Luxonus Inc, Kawasaki, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Park SO, Chang H, Imanishi N. Differences of the midline-crossing venous drainage pattern in supraumbilical and infraumbilical regions: Angiographic study using fresh cadavers. PLoS One 2020; 15:e0242214. [PMID: 33196658 PMCID: PMC7668592 DOI: 10.1371/journal.pone.0242214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/28/2020] [Indexed: 12/02/2022] Open
Abstract
Current clinical and anatomical studies show that the venous problem associated with the deep inferior epigastric perforator flap results from poor midline-crossing. We examined the venous anatomy of the infraumbilical midline area and the dynamic venous flow of the deep inferior epigastric perforator flap in nine fresh cadavers. All nine abdominal specimens were harvested between the subcostal margin and the groin crease. Two specimens were used to analyze the abdominal venous anatomy, one of which was divided into two hemi-abdominal specimens. The remaining seven specimens were harvested as deep inferior epigastric perforator flaps with one major paraumbilical perforator. Venous cannulation and serial angiographic agent injection were performed in several conditions. Each specimen was radiographed using a soft X-ray system. For additional information, computed tomography (CT) angiography-visualized superficial inferior epigastric veins (SIEVs) and the supraumbilical branch were analyzed. We noted that the venous drainage between the bilateral SIEVs was easier to configure in the supraumbilical area than in the infraumbilical area. Only one to two short polygonal venous networks connect the bilateral superficial inferior epigastric veins in the supraumbilical area; however, long and multiple polygonal venous networks connect the bilateral superficial inferior epigastric veins in the infraumbilical area, which could be a predisposing factor for venous congestion. The mean distance from the umbilicus upper border to evident supraumbilical midline crossover was 18.39±4.03 mm (range: 10.10–28.49) in CT angiograms. In cadaver specimens, the mean distance was 10.87±4.85 mm (range: 4.6–18.9). Supraumbilical midline crossover was more favorable than infraumbilical midline crossover in venous flow.
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Affiliation(s)
- Seong Oh Park
- Department of Plastic and Reconstructive Surgery, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea
| | - Hak Chang
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University College of Medicine, Tokyo, Japan
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Kajita H, Suzuki Y, Takatsume Y, Oh A, Takemaru M, Watanabe S, Imanishi N, Jinzaki M, Aiso S, Kishi K. Correlations between Tracer Injection Sites and Lymphatic Pathways in the Leg: A Near-Infrared Fluorescence Lymphography Study. Plast Reconstr Surg 2020; 146:234e-235e. [PMID: 32740621 DOI: 10.1097/prs.0000000000007012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yushi Suzuki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | - Anna Oh
- Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan
| | - Masashi Takemaru
- Department of Plastic and Reconstructive Surgery, Tochigi Cancer Center, Tochigi, Japan
| | - Shiho Watanabe
- Department of Plastic and Reconstructive Surgery, Saiseikai Central Hospital, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Sadakazu Aiso
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan, SIT Research Laboratories, Shibaura Institute of Technology, Tokyo, Japan, Management Division, Luxonus, Inc., Kanagawa, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Suzuki Y, Kajita H, Konishi N, Oh A, Urano M, Watanabe S, Asao Y, Imanishi N, Tsuji T, Jinzaki M, Aiso S, Kishi K. Subcutaneous Lymphatic Vessels in the Lower Extremities: Comparison between Photoacoustic Lymphangiography and Near-Infrared Fluorescence Lymphangiography. Radiology 2020; 295:469-474. [PMID: 32096709 DOI: 10.1148/radiol.2020191710] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Detailed visualization of the lymphatic vessels would greatly assist in the diagnosis and monitoring of lymphatic diseases and aid in preoperative planning of lymphedema surgery and postoperative evaluation. Purpose To evaluate the usefulness of photoacoustic imaging (PAI) for obtaining three-dimensional images of both lymphatic vessels and surrounding venules. Materials and Methods In this prospective study, the authors recruited healthy participants from March 2018 to January 2019 and imaged lymphatic vessels in the lower limbs. Indocyanine green (5.0 mg/mL) was injected into the subcutaneous tissue of the first and fourth web spaces of the toes and below the lateral malleolus. After confirmation of the lymphatic flow with near-infrared fluorescence (NIRF) imaging as the reference standard, PAI was performed over a field of view of 270 × 180 mm. Subsequently, the number of enhancing lymphatic vessels was counted in both proximal and distal areas of the calf and compared between PAI and NIRF. Results Images of the lower limbs were obtained with PAI and NIRF in 15 participants (three men, 12 women; average age, 42 years ± 12 [standard deviation]). All participants exhibited a linear pattern on NIRF images, which is generally considered a reflection of good lymphatic function. A greater number of lymphatic vessels were observed with PAI than with NIRF in both the distal (mean: 3.6 vessels ± 1.2 vs 2.0 vessels ± 1.1, respectively; P < .05) and proximal (mean: 6.5 vessels ± 2.6 vs 2.6 vessels ± 1.6; P < .05) regions of the calf. Conclusion Compared with near-infrared fluorescence imaging, photoacoustic imaging provided a detailed, three-dimensional representation of the lymphatic vessels and facilitated an increased understanding of their relationship with the surrounding venules. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Lillis and Krishnamurthy in this issue.
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Affiliation(s)
- Yushi Suzuki
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Hiroki Kajita
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Nobuko Konishi
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Anna Oh
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Moemi Urano
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Shiho Watanabe
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Yasufumi Asao
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Nobuaki Imanishi
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Tetsuya Tsuji
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Masahiro Jinzaki
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Sadakazu Aiso
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
| | - Kazuo Kishi
- From the Departments of Plastic and Reconstructive Surgery (Y.S., H.K., S.W., K.K.), Rehabilitation Medicine (N.K., T.T.), Anatomy (M.U., N.I., S.A.), and Radiology (M.J.), Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Plastic and Reconstructive Surgery, Tachikawa Hospital, Tokyo, Japan (A.O.); and Luxonus, Kawasaki, Japan (Y.A., S.A.)
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Kono T, Imanishi N, Nozawa K, Takashima A, Maheswari RU, Gonome H, Yamada J. Optical characteristics of human skin with hyperpigmentation caused by fluorinated pyrimidine anticancer agent. Biomed Opt Express 2019; 10:3747-3759. [PMID: 31452972 PMCID: PMC6701539 DOI: 10.1364/boe.10.003747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/22/2019] [Accepted: 06/22/2019] [Indexed: 06/10/2023]
Abstract
The fluorinated pyrimidine anticancer agent has several side effects that degrade the quality of life of patients, including hyperpigmentation. Hyperpigmentation differs in color from common pigmentation such as a suntan, giving rise to dramatic skin appearance changes. In this study, we measured the optical properties of the skin of patients with hyperpigmentation by using the reflection spatial profile method (RSPM). The absorption coefficient in hyperpigmentation increased ~1.5-2.5 times and pheomelanin significantly increased compared to the normal skin. In addition, the scattering coefficient of skin with hyperpigmentation was about 65.9-76.5% of that of normal skin.
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Affiliation(s)
- Takahiro Kono
- Shibaura Institute of Technology, 3-7-5 Toyosu, Koto-ku, Tokyo, 135-8548, Japan
| | - Nobuaki Imanishi
- Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Keiko Nozawa
- National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Atsuo Takashima
- National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | | | - Hiroki Gonome
- Yamagata University, 4-3-16 Jonan, Yonezawa-shi, Yamagata, 992-8510, Japan
| | - Jun Yamada
- Shibaura Institute of Technology, 3-7-5 Toyosu, Koto-ku, Tokyo, 135-8548, Japan
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Kajita H, Oh A, Urano M, Takemaru M, Imanishi N, Otaki M, Yagi T, Aiso S, Kishi K. Photoacoustic lymphangiography. J Surg Oncol 2019; 121:48-50. [PMID: 31165483 DOI: 10.1002/jso.25575] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/12/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Photoacoustic lymphangiography, which is based on photoacoustic technology, is an optical imaging that visualizes the distribution of light absorbing tissue components like hemoglobin or melanin, as well as optical absorption contrast imaging agents like indocyanine green (ICG) in the lymphatic channels, with high spatial resolution. In this report, we introduce the three-dimensional (3D) images of human lymphatic vessels obtained with photoacoustic lymphangiography. METHODS We used the 3D photoacoustic visualization system (PAI-05). Some healthy subjects and lymphedema patients were recruited. To image the lymphatic structures of the limbs ICG was administered subcutaneously as in fluorescence lymphangiography. Photoacoustic images were acquired by irradiating the tissue using a laser at wavelengths of near-infrared region. On the same occasion, fluorescence images were also recorded. RESULTS The lymphatic vessels up to the diameter of 0.2 mm could be observed three-dimensionally with the venules around them. In the patient-group, dermal backflow patterns were often observed as dense interconnecting 3D structures of lymphatic vessels. Collecting vessels passing below the dermis were also observed, which were not observed by fluorescence lymphography. CONCLUSIONS Photoacoustic lymphangiography provided the detailed observation of each lymphatic vessel, leading to deeper understanding of 3D structures and physiological state of the vessel.
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Affiliation(s)
- Hiroki Kajita
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Anna Oh
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Moemi Urano
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Masashi Takemaru
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Marika Otaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Yagi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan.,Department of Technology Development, Luxonus Inc., Kawasaki, Kanagawa, Japan
| | - Sadakazu Aiso
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan.,SIT Research Laboratories, Shibaura Institute of Technology, Tokyo, Japan.,Management Division, Luxonus Inc., Kawasaki, Kanagawa, Japan
| | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Nakamura M, Tanaka K, Hayashi S, Morisada T, Iwata T, Imanishi N, Aoki D. Local anatomy around terminal ureter related to the anterior leaf of the vesicouterine ligament in radical hysterectomy. Eur J Obstet Gynecol Reprod Biol 2019; 235:66-70. [PMID: 30798083 DOI: 10.1016/j.ejogrb.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 01/30/2019] [Accepted: 02/02/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Radical hysterectomy is performed for invasive cervical cancer. In this surgery, separation of the anterior leaf and posterior leaves of the vesicouterine ligament (VUL) is important. We studied the local anatomy of the anterior leaf of the VUL, especially the branches of the umbilical artery from the view point of surgery and cadaver dissection. STUDY DESIGN We observed the cervicovesical blood vessels and the connective tissue layer continued from umbilical artery and searched for the origin of the cervicovesical blood vessels in radical hysterectomy. We also dissected a formalin-fixed female cadaver, and observed the same points. RESULTS After separation of the connective tissue of urinary bladder from the cervical fascia, we could discern the outline of the distal ureter near the ureterovesical junction. We separate the connective tissue of the so-called anterior leaf of the VUL enwrapping the ureter gently, and then the ureter with the connective tissue is completely rolled out laterally. We identified a cervicovesical vessel crossing over the ureter. We looked for the central side of the cervicovesical vessel and found that cervicovesical vessel was a branch of the superior vesical artery. And, during cadaver dissection, we found that the connective tissue and the branches of the superior vesical artery were similarly observed. CONCLUSIONS We found the precise anatomy of the connective tissue layer from umbilical artery to urinary bladder and the superior vesical artery. Our procedure based on the precise anatomy obtained in this study is reasonable anatomically as a method for separation of the vesicouterine ligament during radical hysterectomy.
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Affiliation(s)
- Masaru Nakamura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan.
| | - Kyoko Tanaka
- Department of Obstetrics and Gynecology, Toho University School of Medicine, Japan
| | - Shigenori Hayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Tohru Morisada
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Takashi Iwata
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
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Oishi Y, Akiyama T, Mizutani K, Horiguchi T, Imanishi N, Yoshida K. An analysis of the anatomic route of the hypoglossal nerve within the hypoglossal canal using dynamic computed tomography angiography in patients with anterior condylar arteriovenous fistulas. Clin Neurol Neurosurg 2018; 174:207-213. [PMID: 30278296 DOI: 10.1016/j.clineuro.2018.09.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/19/2018] [Accepted: 09/23/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The venous outlet of anterior condylar arteriovenous fistulas (AC-AVFs) often empties into the anterior condylar vein (ACV). Hypoglossal nerve palsy is one of the major complications after transvenous embolization (TVE) for the AC-AVF within the hypoglossal canal. However, no studies have investigated the route of the hypoglossal nerve within the hypoglossal canal in AC-AVF. The aim of the current study is to retrospectively verify the anatomical route of the hypoglossal nerve within its canal using dynamic computed tomography angiography (CTA) in order to facilitate the safe TVE for AC-AVF. PATIENTS AND METHODS We included five patients with AC-AVF from 2011 to 2017. Dynamic CTA was performed on all patients. When the ACV was well-visualized by dynamic CTA, the hypoglossal nerve could be recognized as a less-intense structure within the surrounding enhanced vasculatures and the nerve route within the canal was analyzed. We also analyzed the location of the fistulas by digital subtraction angiography and cone-beam computed tomography. RESULTS In all five patients, the filling defect of the hypoglossal nerve ran through the most caudal portion of the hypoglossal canal. The fistulous pouches were located in the hypoglossal canal in three cases, and in the jugular tubercle venous complex in two cases. In all three cases with AC-AVF in the hypoglossal canal, the fistulous pouches were located in the superior wall of the hypoglossal canal, which means superior to the ACV. We performed TVE in four patients and none developed post-therapeutic hypoglossal nerve palsy. CONCLUSION In the current study, dynamic CTA is useful for detecting the hypoglossal nerve within the hypoglossal canal. The hypoglossal nerve usually ran the bottom of its canal and the fistulous pouches were usually located at the superior aspect of the canal opposite side to the hypoglossal nerve. Accordingly, the selective embolization within the fistulous pouch located in the superior aspect of the ACV including jugular tubercle venous complex can reduce the risk of hypoglossal nerve palsy.
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Affiliation(s)
- Yumiko Oishi
- Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Takenori Akiyama
- Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan.
| | - Katsuhiro Mizutani
- Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Takashi Horiguchi
- Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Kazunari Yoshida
- Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
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Adachi T, Imanishi N, Umehara S, Izumida Y, Matsumoto N, Kosaki K, Matsubara Y, Mizusawa H, Suematsu M. 744 Japans initiative on rare and undiagnosed diseases patients: To bring their diagnostic odyssey to an end, and beyond. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
D-serine is an endogenous ligand for N-methyl-D-aspartate glutamate receptors. Accumulating evidence including genetic associations of D-serine metabolism with neurological or psychiatric diseases suggest that D-serine is crucial in human neurophysiology. However, distribution and regulation of D-serine in humans are not well understood. Here, we found that D-serine is heterogeneously distributed in the human central nervous system (CNS). The cerebrum contains the highest level of D-serine among the areas in the CNS. There is heterogeneity in its distribution in the cerebrum and even within the cerebral neocortex. The neocortical heterogeneity is associated with Brodmann or functional areas but is unrelated to basic patterns of cortical layer structure or regional expressional variation of metabolic enzymes for D-serine. Such D-serine distribution may reflect functional diversity of glutamatergic neurons in the human CNS, which may serve as a basis for clinical and pharmacological studies on D-serine modulation.
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Affiliation(s)
- Masataka Suzuki
- 1 Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- 1 Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | | | - Kenji Hamase
- 3 Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
| | - Sadakazu Aiso
- 1 Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Jumpei Sasabe
- 1 Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
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Sato Y, Sekine K, Shibusawa T, Tajima K, Sasaki J, Imanishi N, Aiso S, Hori S. Effect of Retroperitoneal Pelvic Packing on Pelvic Cavity Pressure: A Cadaveric Study. Orthopedics 2017; 40:e947-e951. [PMID: 28934537 DOI: 10.3928/01477447-20170918-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 07/31/2017] [Indexed: 02/03/2023]
Abstract
Limited clinical evidence demonstrates the effectiveness of direct retroperitoneal pelvic packing for hemorrhage control in pelvic fractures due to the difficulty in measuring pressure on the pelvic walls within the pelvic cavity after retroperitoneal pelvic packing. Using a cadaver model, the authors aimed to assess whether retroperitoneal pelvic packing generates pressure that exceeds the venous return and arterial pressure in the pelvis. The pressure on the pelvic wall was measured in 5 fresh Japanese cadavers. Sensors were placed at 4 points on the pelvic wall, and the pressure at each point was measured after the insertion of each of 3 sponges, per the procedure originally described for direct retroperitoneal pelvic packing. In each specimen, the average pressure across all 4 points on the pelvic wall increased with the addition of each sponge, reaching 12.3±4.5 mm Hg when all 3 sponges were inserted. Furthermore, the pressure at the pelvic floor and posterior pelvic brim increased significantly, whereas the pressure at the anterior and middle pelvic brim increased nonsignificantly. The results of this study suggest that retroperitoneal pelvic packing provides pressure on the pelvic wall that exceeds the venous pressure and is thus effective for the control of venous hemorrhage in pelvic fractures. Currently, the recommended procedure combines external fixation for venous bleeding, transcatheter arterial embolization, and pelvic packing; however, the authors' results suggest that pelvic packing alone may be effective for controlling venous hemorrhage in pelvic fracture. [Orthopedics. 2017; 40(6);e947-e951.].
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Chikaishi Y, Takenaka M, Kuroda K, Imanishi N, Tanaka F. V-009A CASE OF MEDIASTINAL TRACHEOSTOMY FOR TRACHEOSTENOSIS AFTER TRACHEOSTOMY WITH TRACHEOMALACIA BY MUCOPOLYSACCHARIDOSIS. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ito K, Hosoda K, Shimizu M, Ikemoto S, Nagura T, Seki H, Kitashiro M, Imanishi N, Aiso S, Jinzaki M, Ogihara N. Three-dimensional innate mobility of the human foot bones under axial loading using biplane X-ray fluoroscopy. R Soc Open Sci 2017; 4:171086. [PMID: 29134100 PMCID: PMC5666283 DOI: 10.1098/rsos.171086] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/18/2017] [Indexed: 05/13/2023]
Abstract
The anatomical design of the human foot is considered to facilitate generation of bipedal walking. However, how the morphology and structure of the human foot actually contribute to generation of bipedal walking remains unclear. In the present study, we investigated the three-dimensional kinematics of the foot bones under a weight-bearing condition using cadaver specimens, to characterize the innate mobility of the human foot inherently prescribed in its morphology and structure. Five cadaver feet were axially loaded up to 588 N (60 kgf), and radiographic images were captured using a biplane X-ray fluoroscopy system. The present study demonstrated that the talus is medioinferiorly translated and internally rotated as the calcaneus is everted owing to axial loading, causing internal rotation of the tibia and flattening of the medial longitudinal arch in the foot. Furthermore, as the talus is internally rotated, the talar head moves medially with respect to the navicular, inducing external rotation of the navicular and metatarsals. Under axial loading, the cuboid is everted simultaneously with the calcaneus owing to the osseous locking mechanism in the calcaneocuboid joint. Such detailed descriptions about the innate mobility of the human foot will contribute to clarifying functional adaptation and pathogenic mechanisms of the human foot.
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Affiliation(s)
- Kohta Ito
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama 223-8522, Japan
- Authors for correspondence: Kohta Ito e-mail:
| | - Koh Hosoda
- Department of System Innovation, Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
| | - Masahiro Shimizu
- Department of System Innovation, Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
| | - Shuhei Ikemoto
- Department of System Innovation, Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
| | - Takeo Nagura
- School of Medicine, Keio University, Tokyo, Japan
| | | | | | | | | | | | - Naomichi Ogihara
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama 223-8522, Japan
- Authors for correspondence: Naomichi Ogihara e-mail:
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Chikaishi Y, Takenaka M, Kuroda K, Imanishi N, Tanaka F. V-039COMPLETE RESECTION OF THE ANTERIOR MEDIASTINAL TUMOUR THROUGH TOTAL ARCH REPLACEMENT AND PULMONARY ARTERY TRUNK RESECTION WITH A PERICARDIUM PATCH. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chikaishi Y, Takenaka M, Kuroda K, Imanishi N, Tanaka F. P-271COMPLETE RESECTION OF THE PRIMARY LESION FOR STAGE IV NON-SMALL CELL LUNG CANCER. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Park SO, Ahn KC, Hong KY, Chang H, Imanishi N. External jugular veno-accompanying artery adipofascial flap: A novel and convenient flap for head and neck reconstruction. Head Neck 2017; 39:2249-2255. [DOI: 10.1002/hed.24894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/19/2017] [Accepted: 06/16/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Seong Oh Park
- Department of Plastic and Reconstructive Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Kyung Chan Ahn
- Department of Plastic and Reconstructive Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Ki Yong Hong
- Department of Plastic and Reconstructive Surgery; Dongguk University Medical Center; Goyang Korea
| | - Hak Chang
- Department of Plastic and Reconstructive Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Nobuaki Imanishi
- Department of Anatomy; Keio University College of Medicine; Tokyo Japan
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Ito K, Hosoda K, Shimizu M, Ikemoto S, Nagura T, Seki H, Kitashiro M, Jinzaki M, Imanishi N, Aiso S, Ogihara N. Three-dimensional measurement of the human cadaver foot bone kinematics under axial loading condition using biplane X-ray fluoroscopy. Footwear Science 2017. [DOI: 10.1080/19424280.2017.1314387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kishi K, Katsube K, Satoh H, Imanishi N, Nakajima H, Nakajima T. The Fetal Dermal but Not Loose Fascial Mesenchymal Cells Possess Regenerative Activity of Dermal Structure. Cell Transplant 2017; 14:709-14. [PMID: 16405082 DOI: 10.3727/000000005783982729] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Fetal skin possesses a regenerative activity until certain developmental stages. However, the origin of cells that regenerate dermis after wounding has not been clarified yet. In the present study we located the origin of cells that reconstruct fetal dermal structure by histological examination and by marking cells in the loose fascia. Next we evaluated the regenerative activity of fetal dermal mesenchymal cells by cotransplanting with fetal epidermal cells onto the skin defect of scid mice. We conclude that fetal dermal mesenchymal cells but not loose fascial cells possess regenerative activity even on the environment in scid mice.
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Affiliation(s)
- Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan.
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Onishi S, Imanishi N, Yoshimura Y, Inoue Y, Sakamoto Y, Chang H, Okumoto T. Venous drainage of the face. J Plast Reconstr Aesthet Surg 2017; 70:433-440. [DOI: 10.1016/j.bjps.2016.11.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 11/15/2016] [Accepted: 11/30/2016] [Indexed: 10/20/2022]
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Kasai S, Nagasao T, Sakamoto Y, Shimizu Y, Imanishi N, Kishi K. An anatomical study on the availability of contralateral recipient vessels in hemi-mandibular reconstruction with vascularised free fibula transfer. J Plast Surg Hand Surg 2017; 51:358-361. [DOI: 10.1080/2000656x.2017.1281820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Shogo Kasai
- Department of Plastic and Reconstructive Surgery, Keio University, Tokyo, Japan
| | - Tomohisa Nagasao
- Department of Plastic, Reconstructive and Aesthetic Surgery, Kagawa University, School of Medicine, Takamatsu, Japan
| | - Yoshiaki Sakamoto
- Department of Plastic and Reconstructive Surgery, Keio University, Tokyo, Japan
| | - Yusuke Shimizu
- Department of Plastic and Reconstructive Surgery, Ryukyu University Hospital, Naha, Japan
| | | | - Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, Keio University, Tokyo, Japan
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Takenaka M, Oyama R, Kobayashi K, Yura S, Matsumiya H, Shinohara S, Kuwata T, Oka S, Chikaishi Y, Hirai A, Yoneda K, Tashima Y, Kuroda K, Imanishi N, Nagata Y, Tanaka F. V-072A CASE OF CERVICO-MEDIASTINAL LIPOSARCOMA REQUIRING PHARYNGO-LARYNGO-OESOPHAGEAL RESECTION, WITH FREE JEJUNAL GRAFT AND ANTERIOR MEDIASTINAL TRACHEOSTOMY WITH PEDICLED OMENTAL FLAP. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tsukada J, Yamada M, Yamada Y, Yamazaki S, Imanishi N, Tamura K, Hashimoto M, Nakatsuka S, Jinzaki M. Comparison of the diagnostic accuracy of FBP, ASiR, and MBIR reconstruction during CT angiography in the evaluation of a vessel phantom with calcified stenosis in a distal superficial femoral artery in a cadaver extremity. Medicine (Baltimore) 2016; 95:e4127. [PMID: 27399123 PMCID: PMC5058852 DOI: 10.1097/md.0000000000004127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To investigate whether adaptive statistical iterative reconstruction (ASiR) or model-based iterative reconstruction (MBIR) improves the diagnostic performance of computed tomography angiography (CTA) for small-vessel calcified lesions relative to filtered back projection (FBP) using cadaver extremities and a calcified stenosis phantom. METHODS A cadaver was used in accordance with our institutional regulations, and a calcified stenosis phantom simulating 4 grades of stenosis was prepared. The phantom was inserted within the distal superficial femoral artery of the cadaver leg. Ten CT images per reconstruction type and stenosis grade were acquired using a 64-slice multidetector-row CTA.As an objective measurement, the first and second derivatives of the CT value function profiles were calculated. As a subjective measurement, 2 blinded reviewers measured the stenosis ratio using a quantitative scale. The Wilcoxon rank-sum test was used to evaluate the data. RESULTS Objective measurements of both 25% and 50% stenosis differed significantly (P < 0.01) between MBIR (25/50%: 25.80/50.30 ± 3.88/3.86%) and FBP (25/50%: 35.60/83.80 ± 3.44/26.10%), whereas significant differences were not observed between ASiR and FBP.Reviewer 2's subjective measurements of 25% stenosis differed significantly (P < 0.01) between MBIR (35.13 ± 3.25%) and ASiR (40.89 ± 3.14%), and the measurements of 50% stenosis differed significantly (P < 0.01) between MBIR (reviewers 1/2, 62.36/54.78 ± 2.78/4.96%) and FBP (reviewers 1/2, 62.36/74.84 ± 2.78/18.10%). Significant differences in the subjective measurements were not observed between ASiR and FBP. CONCLUSION MBIR improves the diagnostic performance of CTA for small-vessel calcified lesions relative to FBP.
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Affiliation(s)
- Jitsuro Tsukada
- Department of Diagnostic Radiology, Keio University School of Medicine
| | - Minoru Yamada
- Multi-Dimension Biomedical Imaging and Information Laboratory in Research Park, Keio University School of Medicine
| | - Yoshitake Yamada
- Department of Diagnostic Radiology, Keio University School of Medicine
| | - Shun Yamazaki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Tamura
- Department of Diagnostic Radiology, Keio University School of Medicine
| | | | - Seishi Nakatsuka
- Department of Diagnostic Radiology, Keio University School of Medicine
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology, Keio University School of Medicine
- Correspondence: Masahiro Jinzaki, Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan (e-mail: )
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Park SO, Chang H, Imanishi N. The free serratus anterior artery perforator flap-A case report and anatomic study. Microsurgery 2016; 36:339-344. [PMID: 26901798 DOI: 10.1002/micr.30038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/22/2015] [Accepted: 01/22/2016] [Indexed: 11/09/2022]
Abstract
We report a reconstructive case using a free serratus anterior artery perforator flap and an anatomic study. A 50-year-old man with upper esophageal sphincter stricture underwent segmental cervical esophageal resection. The size of the defect was approximately 5.5 cm. We then performed esophageal reconstruction using the free serratus anterior artery perforator flap. Esophagography performed on postoperative day 7 revealed no definite leakage and a viable anastomosis site with wide patency. No complications developed during the long-term follow-up period of 3 years. We reviewed the literature and performed an anatomic study using four fresh cadavers. We performed an angiographic study using two specimens and dissection of this perforator using other two specimens. We found that a direct connection existed between the serratus anterior artery and intercostal perforator to the skin in two of eight chests. The connection was located at the 4th intercostal space in the left chest of one cadaver and at the 6th/7th intercostal space in the left chest of the other cadaver. The free serratus anterior artery perforator flap is a new flap that could be considered for use during the elevation of a perforator flap in the lateral chest area, and especially in the area overlying the serratus anterior muscle. © 2016 Wiley Periodicals, Inc. Microsurgery 36:339-344, 2016.
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Affiliation(s)
- Seong Oh Park
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hak Chang
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University College of Medicine, Tokyo, Japan
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Chaves LF, Imanishi N, Hoshi T. Population dynamics of Armigeres subalbatus (Diptera: Culicidae) across a temperate altitudinal gradient. Bull Entomol Res 2015; 105:589-597. [PMID: 26074401 DOI: 10.1017/s0007485315000474] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Understanding the impacts of weather fluctuations, and environmental gradients, on the abundance of vectors is fundamental to grasp the dynamic nature of the entomological risk for disease transmission. The mosquito Armigeres subalbatus (Coquillet) is a common vector of filariasis. Nevertheless, its population dynamics have been relatively poorly studied. Here, we present results from a season long study where we studied spatio-temporal abundance patterns of Ar. subalbatus across the altitudinal gradient of Mt. Konpira in Nagasaki, Japan. Spatially, we found that abundance of adult Ar. subalbatus decreased with altitude and increased in areas where the ground was rich in leaf litter. Similarly, adult activity was observed only when relative humidity was over 65%. Temporally, we found that peaks in abundance followed large rainfall events. Nevertheless, this mosquito was under significant density dependence regulation. Our results suggest that Ar. subalbatus population peaks following large rainfall events could reflect the recruitment of individuals that were dormant as dry eggs. We did not find a clear signal of temperature on abundance changes of this mosquito, but only on its phenology. Since ground cover seemed more critical than temperature to its spatial distribution, we propose that this mosquito might have some degree of autonomy to changes in temperature.
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Affiliation(s)
- L F Chaves
- Institute of Tropical Medicine (NEKKEN),Nagasaki University,Sakamoto 1-12-4,Nagasaki 852-8523,Japan
| | - N Imanishi
- Institute of Tropical Medicine (NEKKEN),Nagasaki University,Sakamoto 1-12-4,Nagasaki 852-8523,Japan
| | - T Hoshi
- Institute of Tropical Medicine (NEKKEN),Nagasaki University,Sakamoto 1-12-4,Nagasaki 852-8523,Japan
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Sasabe J, Suzuki M, Imanishi N, Aiso S. Activity of D-amino acid oxidase is widespread in the human central nervous system. Front Synaptic Neurosci 2014; 6:14. [PMID: 24959138 PMCID: PMC4050652 DOI: 10.3389/fnsyn.2014.00014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/20/2014] [Indexed: 12/11/2022] Open
Abstract
It has been proposed that D-amino acid oxidase (DAO) plays an essential role in degrading D-serine, an endogenous coagonist of N-methyl-D-aspartate (NMDA) glutamate receptors. DAO shows genetic association with amyotrophic lateral sclerosis (ALS) and schizophrenia, in whose pathophysiology aberrant metabolism of D-serine is implicated. Although the pathology of both essentially involves the forebrain, in rodents, enzymatic activity of DAO is hindbrain-shifted and absent in the region. Here, we show activity-based distribution of DAO in the central nervous system (CNS) of humans compared with that of mice. DAO activity in humans was generally higher than that in mice. In the human forebrain, DAO activity was distributed in the subcortical white matter and the posterior limb of internal capsule, while it was almost undetectable in those areas in mice. In the lower brain centers, DAO activity was detected in the gray and white matters in a coordinated fashion in both humans and mice. In humans, DAO activity was prominent along the corticospinal tract, rubrospinal tract, nigrostriatal system, ponto-/olivo-cerebellar fibers, and in the anterolateral system. In contrast, in mice, the reticulospinal tract and ponto-/olivo-cerebellar fibers were the major pathways showing strong DAO activity. In the human corticospinal tract, activity-based staining of DAO did not merge with a motoneuronal marker, but colocalized mostly with excitatory amino acid transporter 2 and in part with GFAP, suggesting that DAO activity-positive cells are astrocytes seen mainly in the motor pathway. These findings establish the distribution of DAO activity in cerebral white matter and the motor system in humans, providing evidence to support the involvement of DAO in schizophrenia and ALS. Our results raise further questions about the regulation of D-serine in DAO-rich regions as well as the physiological/pathological roles of DAO in white matter astrocytes.
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Affiliation(s)
- Jumpei Sasabe
- Department of Anatomy, Keio University School of Medicine Shinjuku-ku, Tokyo, Japan
| | - Masataka Suzuki
- Department of Anatomy, Keio University School of Medicine Shinjuku-ku, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine Shinjuku-ku, Tokyo, Japan
| | - Sadakazu Aiso
- Department of Anatomy, Keio University School of Medicine Shinjuku-ku, Tokyo, Japan
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Matsui M, Takahashi K, Sakamoto K, Hirano A, Takeda Y, Yamamoto O, Imanishi N. Phase stability of a garnet-type lithium ion conductor Li7La3Zr2O12. Dalton Trans 2014; 43:1019-24. [DOI: 10.1039/c3dt52024b] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Nakamura M, Fujii T, Imanishi N, Jinzaki M, Yamada M, Kuribayashi S, Aoki D. Surgical anatomy imaging associated with cervical cancer treatment: A cadaveric study. Clin Anat 2013; 27:503-10. [DOI: 10.1002/ca.22319] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 08/10/2013] [Accepted: 08/16/2013] [Indexed: 01/18/2023]
Affiliation(s)
- Masaru Nakamura
- Department of Obstetrics and Gynecology; Keio University School of Medicine; Tokyo Japan
| | - Takuma Fujii
- Department of Obstetrics and Gynecology; Keio University School of Medicine; Tokyo Japan
- Department of Obstetrics and Gynecology; Fujita Health University School of Medicine; Aichi Japan
| | - Nobuaki Imanishi
- Department of Anatomy; Keio University School of Medicine; Tokyo Japan
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology; Keio University School of Medicine; Tokyo Japan
| | - Minoru Yamada
- Multi-dimension Biomedical Imaging & Information Laboratory in Research Park, Keio University School of Medicine; Tokyo Japan
| | - Sachio Kuribayashi
- Department of Diagnostic Radiology; Keio University School of Medicine; Tokyo Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology; Keio University School of Medicine; Tokyo Japan
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Affiliation(s)
- Yoshiaki Sakamoto
- Department of Plastic and Reconstructive Surgery; Keio University School of Medicine; Tokyo; Japan
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Matsumura N, Nakamichi N, Ikegami H, Nagura T, Imanishi N, Aiso S, Toyama Y. The function of the clavicle on scapular motion: a cadaveric study. J Shoulder Elbow Surg 2013; 22:333-9. [PMID: 22608930 DOI: 10.1016/j.jse.2012.02.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 02/18/2012] [Accepted: 02/21/2012] [Indexed: 02/01/2023]
Abstract
HYPOTHESIS The clavicle serves as a strut between the thorax and scapula, and lack of this function could affect shoulder mobility. We hypothesized that clavicular discontinuity changes shoulder kinematics, particularly affecting scapular motion. MATERIALS AND METHODS The study used 14 cadaveric shoulders. Cadavers were stabilized in the sitting position. Manual elevation in the sagittal, scapular, and coronal planes was performed in the intact and clavicular discontinuity models. The thorax-scapula distance and 3-dimensional scapular motion during shoulder elevation were recorded using an electromagnetic tracking device. The differences between the 2 experimental models at each position were analyzed. RESULTS Clavicular discontinuity resulted in a decreased thorax-scapula distance and in reduced external rotation, upward rotation, and posterior tilting of the scapula. The kinematic changes were observed during elevations in all 3 planes but were greatest in the sagittal plane compared with the scapular and coronal planes. CONCLUSIONS The findings of this study revealed that discontinuity of the clavicle affects shoulder kinematics. Because of its anatomic shape and position, the clavicle stabilizes the external, upward, and posterior rotation of the scapula during arm movement. This function of the clavicle may assist glenohumeral joint motion and help prevent subacromial impingement. LEVEL OF EVIDENCE Basic Science Study, Biomechanics, Cadaver Model.
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Affiliation(s)
- Noboru Matsumura
- Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan.
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Yamazaki S, Suami H, Imanishi N, Aiso S, Yamada M, Jinzaki M, Kuribayashi S, Chang DW, Kishi K. Three-dimensional demonstration of the lymphatic system in the lower extremities with multi-detector-row computed tomography: A study in a cadaver model. Clin Anat 2013; 26:258-66. [DOI: 10.1002/ca.22179] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 09/10/2012] [Accepted: 09/12/2012] [Indexed: 02/06/2023]
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Shimizu Y, Imanishi N, Nakajima T, Nakajima H, Aiso S, Kishi K. Venous architecture of the glabellar to the forehead region. Clin Anat 2012; 26:183-95. [DOI: 10.1002/ca.22143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 06/29/2012] [Accepted: 07/05/2012] [Indexed: 11/06/2022]
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Abstract
OBJECTIVE To describe a 1-step nasal reconstruction technique for use in lieu of a paramedian forehead flap that is usually raised at the location of the supratrochlear artery. METHODS Using angiography in 10 fresh cadavers, we confirmed the arterial anatomy of the nasal and forehead regions to refine the paramedian forehead flap. Based on the anatomical data, we performed nasal reconstruction in 6 patients who had a full-thickness defect of the nasal ala or who needed alar base reconstruction with an island paramedian forehead flap based on the angular artery. RESULTS From the anatomical study, we confirmed a rich network among the supratrochlear, dorsonasal, and angular arteries around the medial canthus. In the clinical cases, the subcutaneous pedicle was tunneled beneath the skin, without conspicuous bulkiness. For all patients, the operation was completed in 1 stage, and the flaps healed without evidence of necrosis. CONCLUSIONS By moving the pedicle downward, a full-thickness nasal defect can be reconstructed in 1 stage that includes the alar lining or alar base with the paramedian forehead flap. This avoids restriction of the rotation arc, particularly when the alar lining or alar base is also needed for reconstruction.
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Affiliation(s)
- Kazuo Kishi
- Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.
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