Sadao Tsukada

Kanazawa Medical University, Kanazawa, Ishikawa, Japan

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Publications (45)42.3 Total impact

  • Naotaka Ishikura · T Heshiki · Tetsuji Kimura · Sadao Tsukada
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    ABSTRACT: Repair of complete syndactyly by a combination of tissue expansion and composite grafts from the glabrous non-weight bearing areas of the foot has been performed on three syndactylies in two patients. The commissure and the lateral areas of the proximal and middle phalanges were covered with expanded skin and the separated fingertips were covered with composite grafts. Without using an ordinary skin graft, this method can provide aesthetically excellent results with good skin colour and texture.
    No preview · Article · Oct 1995 · British Journal of Plastic Surgery
  • Naotaka Ishikura · Sadao Tsukada
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    ABSTRACT: Many cases of successful replantation of fingertips have been reported; however, it still remains difficult for an inexperienced surgeon to anastomose very small vessels (especially veins of the fingertip) because their walls and lumina cannot be clearly defined. The authors report a simple method which is useful for anastomosis of small vessels. A colored silicone background is cut into a small, thread-like segment, and both ends are tapered. This segment is then introduced into the vessel lumen to serve as a vascular stent. The silicone vascular stent makes it easy to identify the vessel lumen and then to suture the vessel edges. It also prevents a through-stitch, the most common cause of anastomosis failure with small vessels. The silicone vascular stent is removed before the last suture is tied. This technique has been used for suturing small veins in the finger pulp or small arteries in zone I, and it will be most helpful for the inexperienced microsurgeon.
    No preview · Article · Apr 1995 · Journal of Reconstructive Microsurgery
  • Naotaka Ishikura · Takaya Heshiki · Sadao Tsukada
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    ABSTRACT: A free medialis pedis flap was used to repair skin defects of the fingers and hand in five patients, the flap sizes ranging from 2 x 3 cm to 5 x 10 cm. Four flaps survived completely, but the largest flap turned necrotic along the dorsal margin, which is thought to have resulted from an incorrect flap alignment. A free medialis pedis flap possesses several advantages: (1) It is very thin in comparison with other standard free flaps; (2) it can be used for small repairs, unlike many conventional free flaps; (3) it possesses two draining venous pathways, the vena comitans and the subcutaneous veins; (4) the diameters of its vessels are similar to those of the fingers; (5) it provides a good color and texture match for finger repairs; and (6) a good recovery of protective sensation is achievable, probably due to its thinness. However, this flap also has some disadvantages: A skin graft is usually required for donor-site closure, and it cannot be used as a sensory flap.
    No preview · Article · Feb 1995 · Plastic & Reconstructive Surgery
  • Koji Murata · Naotaka Ishikura · Sadao Tsukada

    No preview · Article · Jan 1995 · Nishi Nihon Hifuka
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    ABSTRACT: The anterior skull base of a patient with a craniofacial cleft with naso-ethmoidal encephalocele was reconstructed using temporo-parietal and frontal galea-pericranial flaps and free cranial bone grafts, to prevent meningitis caused by trans-nasal infection. The patient had frequent episodes of meningitis before surgery, however, no episodes of meningitis have been observed up to 1 year postoperatively.
    No preview · Article · Jul 1994 · Journal of Cranio-Maxillofacial Surgery
  • Shigehiko Kawakami · Sadao Tsukada · Wakae Taniguchi
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    ABSTRACT: The superficial temporal vein and retromandibular vein were used as a guide to expose facial nerve branches in the parotid gland, and this procedure was applied to open reduction of mandibular condyle fractures (14 patients) and to superficial parotidectomy (6 patients). The advantages of this method are as follows: It is very easy to identify the superficial temporal vein as a guide, and it produces very little surgical stress because the procedure for exposing the facial nerve branches through the course of the vein is the same as the procedure for exposing the condyle and elevating the superficial lobe of the parotid gland.
    No preview · Article · Apr 1994 · Annals of Plastic Surgery

  • No preview · Article · Jan 1994 · Nishi Nihon Hifuka
  • Sadao TSUKADA · Wakae TANIGUCHI
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    ABSTRACT: ABSTRACT Currently, clefts of the lip, alveolus, and palate are thought to be the most common congenital malformations. In this study, we examined 1,565 cases of clefts we treated over the last 18 years, in order to summarize the clinical features and to evaluate the treatment outcomes. This study involved 589 cleft lip (CL) cases, 576 cleft lip and palate (CLP) cases, 286 cases of cleft palate (CP), 81 cases of submucous CP and 33 cases of CL and submucous CP. The familial incidence was 11.1% (174 cases). Overall, the average incidence of associated congenital abnormalities was 27.9%. Approximately half of the patients with CP alone or with submucous CP were found to have additional congenital malformations. Standeard surgical techniques for unilateral and bilateral CL cases were the Skoog's and Millard's methods, respecively, which resulted in satisfactory outcomes. As a primary operation for CP, pushback procedure was performed using a partial mucosal flap from the palate. Using this procedure 96.5% of 455 cases achieved satisfactory nasopharyngeal closure. The main objective in the treatment of CL patients is not only the repair of growing tissues but also appropriate morphological, functional and psychological reconstruction for the purpose of correcting growth inhibitory problems caused by anatomical malposition. Surgical procedures for CP patients are designed to meet several needs: correction of anatomical abnormalities of the palate and pharynx, achievement of proper nasopharyngeal closure necessary for normal phonation, prevention of growth disturbances of the maxilla, improvements in hearing and auditory tube function, and normalization of occlusion.
    No preview · Article · Nov 1993 · Congenital Anomalies
  • Hiroshi Hayashi · Yoichro Hara · Yukio Yasuda · Sadao Tsukada
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    ABSTRACT: We studied the effectiveness of the Q-switched ruby laser (QRL), RD-1200 (694nm, 20ns), Spectrum Corporation, by treating 86 cases of nevus Ota. The results of the total 86 cass were excellent in 10 cases(12%), good in 64 cases (74%), fair in 5 cases(6%), poor in 7 cases(8%). Satisfactory results (excellent or good) were achieved in 86% of total cases. Those treated once or twice showed the less satisfactory results as fair and poor, while those treated more than three times showed the satisfactory results. No side effects, such as scar formation, abnormal hyper or hypopigmentation, was noted on any case. Histological changes caused by laser irradiation were limited to that of melanosomes and melanin containing cells, other tissue being kept normal. In Practical irradiations no special skill was required, the post-operative treatment being simple. From these findings, it appeared that the QRL was highly effective and safe in the treatment of nevus Ota and repeated multiple treatments to the same site at regular intervals could attain high efficacy.
    No preview · Article · Jan 1993 · Nippon Laser Igakkaishi
  • Hiroshi Hayashi · Hiroshi Noda · Yukio Yasuda · Sadao Tsukada
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    ABSTRACT: We studied the effectiveness of the pulsed dye laser PLDL-1( 510nm, 375ns), Candela Corporation, by treating 223 cases of benign cutaneous pigmented lesions. The conclusion was obtained as follows. The PLDL-1 was very effective for superficial benign pigmentation and was safe without scar formation. Compared to other conventional lasers, the occurrence and the degree of abnormal coloration was very low. Pain was very light and anesthesia was not required. Post operative treatment was very simple and it was of short duration. Those were the strong points of the PLDL-1. Regarding the shortcomings of the PLDL-1, it did not work for lesions that are deep and it has small spot size.The PLDL-1, however, has several advantages over conventional treatment methods. We believe the PLDL-1 is a laser that can be used safely in the clinical scene in the future.
    No preview · Article · Jan 1992 · Nippon Laser Igakkaishi
  • Yukio Yasuda · Hiroshi Hayashi · Sadao Tsukada
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    ABSTRACT: Selective damage of dilated dermal vessels on portwine stains induced by 585nm pulsed dye laser at pulse duration of 450μs (Candela model SPTL-1), and of melanosomes on nevus spilus induced by 510nm pulsed dye laser at pulse duration of 375ns (Candela model PLDL-1) were examined light and electron microscopically.selective photothermolysis was made on portwine stains with minimal scar formation in the dermis and no disorder of epidermal pigmentation. On nevus spilus, melanosomal disruption was accompanied by necrosis of epidermis, and after reepithelization the epidermis showed normal pigmentation except a few cases with hyperpigmentation as nevus spilus.
    No preview · Article · Jan 1992 · Nippon Laser Igakkaishi
  • Yukio Yasuda · Oon T. Tan · Amal K. Kurban · Sadao Tsukada
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    ABSTRACT: Selective damage of epidermal pigment cells induced by 504 nm pulsed dye laser at different pulse durations and fluence on black pig skin was examined electron microscopically. Epidermal melanosomes were satisfactorily disrupted at shorter pulse duration (100 ns). Epidermal blister formation and necrosis were seen at 2 days postirradiation, and reepithelization was evident at 7 days postirradiation in all specimens. Repigmentation was evident 21 to 56 days after irradiation. Histological pigmentary incontinence was evident at 2 days and persisted until 56 days postirradiation. This phenomenon was observed more frequently in skin exposed to longer pulse duration and at low fluences. Optimal parameters required to induce epidermal melanosome disruption using the 504 nm pulsed dye laser will be discussed.
    No preview · Article · Jun 1991 · Proceedings of SPIE - The International Society for Optical Engineering
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    ABSTRACT: 104 patients, 21 days to 67 years of age, with benign cutaneous vascular lesions other than port-wine stains were treated using the flashlamp dye laser (Candela, SPTL-1P SPTL-1), The patients whose lesions did not lighten significantly at the first treatment would receive two or more treatments at intervals of more than one month. At least three months after the final irradiation, evaluation of its effects were made as follows: Excellent; Identical to uninvolved skin, Good; Marked improvement, Fair; Slight improvement, Poor; No improvement.The results of the 104 total patients were excellent in 53 patients (51%), good in 48 (46%), fair in 2 (2%), poor in 1 (1%), Satisfactory results (excellent or good) were achieved in 97% of total patients, 91% of the patients with hemangiomas, 100% of the patients with nevus araneus, angioma serpiginosum or rosacea erythematosa, 98% of the patients with facial telangiectasias.Scarring was observed none of the total patients. Twelve patients developed transient hyper or hypopigmentation, which returned to normal skin color within six months.
    No preview · Article · Jan 1991 · Nippon Laser Igakkaishi
  • Yukio Yasuda · Hlroshi Hayashi · Sadao Tsukada
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    ABSTRACT: Cutaneous blood flow was monitored using L-MAP 10 (M & M Co.) in fourteen patients with soft tissue expansions, nine with skin flaps, seven with fresh burns, seven with replanted fingers, two with full thickness skin grafts, two with composite grafts and eight with port-wine stains.The expanded skins showed significant decrease of blood flow immediately after inflation following quick recovery. In the flaps, low blood flow area were keeping with their subsequent necrosis. Comparing to the deep dermal burns and deep burns, superficial dermal burns showed relatively high blood flow. Decreasing the blood flow in the replanted fingers indicated the failure of their survival. In the skin grafts and the composite grafts, low blood flow area and the necrotic area were positively relational. But in port-wine stains, the levels of blood flow had no relation with the histological depth of abnormal vessels.The results in this study indicate that L-MAP 10 is useful for predicting the clinical survival of various skin lesions in plastic surgery.
    No preview · Article · Jan 1991 · Nippon Laser Igakkaishi
  • Hiroshi HAYASHI · Yukio YASUDA · Sadao TSUKADA
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    ABSTRACT: flashlamp dye laser (Candela SPTL-1P, SPTL-1) を用いて, 295例 (305部位) の単純性血管腫を治療し, その治療成績を検討した。4段階評価による成績は, 著効85部位, 有効186部位, やや有効23部位, 無効11部位で著効と有効をあわせた有効率は89%であった。副作用として問題になるような瘢痕形成は生じなかった。また異常な色素沈着も発生しにくく, 発生しても一過性であった。単純性血管腫に対するflashlamp dye laser治療は安全な治療法であり, 一定期間をおいて同一部位へ繰り返し追加照射を行うことによって, いかなる年齢, どの部位においても高い有効性が獲得できると考えられた。しかし, 色素沈着が強い症例ではレーザー光の透過性が妨げられ, 治療が困難となる。そのような症例に対してはまず削皮術を行ってメラニンの多い表皮を除去, 上皮化後の色素脱失状態の時期に照射を行って好成績を得た。
    No preview · Article · Jan 1991 · Nippon Laser Igakkaishi
  • Yukio YASUDA · Hiroshi HAYASHI · Sadao TSUKADA
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    ABSTRACT: Selective photothermolysis of port-wine stains induced by Candela model SPTL-1P (577nm) and SPTL-1 (585nm) flashlamp pumped pulsed dye lasers were examined light and electron microscopically. Immediately after irradiation, red blood cells agglutination and heat necrosis were found at the dilated vessels in the dermis, and perivascular collagen fibrils necrosis was minimum. Twenty-four hours after irradiation, a lot of inflammatory cells were infiltrated around the necrotic vessels. One month after irradiation, the area in which dilated vessels had showed necrosis was replaced by granulation tissue. No recurrence or scar formation was observed in the dermis 6 months after irradiation. Comparing to SPTL-1P (577nm), SPTL-1 (585nm) showed deeper penetration in the dermis while the selectivity of vessel necrosis was not different between them. In the cases with epidermal hyperpigmentation, epidermal necrosis and reepithelization was found after irradiation. The reepithelized epidermis showed the state of pigment blockade for several weeks, and returned to normal pigmentation within 6 months.
    No preview · Article · Jan 1991 · Nippon Laser Igakkaishi
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    ABSTRACT: Two cases of DNA autosensitivity in Japanese sisters are reported. Both patients developed painful ecchymoses and other bleeding disorders. Skin tests with autologous leukocyte lysates and calf thymus DNA produced intermediate-type reactions that were identical to spontaneous skin reactions. Pretreatment of DNA with either DNase or chloroquine sulfate inhibited these reactions. Our studies suggest that anti-DNA antibodies might contribute to the clinical symptoms of this disorder.
    No preview · Article · Feb 1990 · Arthritis & Rheumatology
  • Yukio Yasuda · Amal K.Kurban · Oon T.Tan · Sadao Tsukada
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    ABSTRACT: We examined the effects of 504nm pulsed dye laser on the black pig skin by light and electron microscope, at the pulse duration of 100ns, 250ns and 500ns at fluences of 1.0 J/cm2 and 2.5J/cm2. Biopsies were made immediately and 2, 7 and 21 days post-irradiation.The irradiated area showed hypopigmentation during 7 to 21 days post-irradiation. Light and electron microscopically, melanosomal disruption was complete at 100ns, but mild at 500ns and vacuoles and piknosis were seen in the basal cells immediately after irradiation. Reepitheliarization was occured at 7 days post-irradiation Histological pigmentary incontinence occured st 2 days and lasted till 21 days post-irradiation. This was observed more frequently at longer pulse duration and lower power dosage.Epidermal pigment appeared to be destroyed completely at shorter pulse duration (100ns).
    No preview · Article · Jan 1990 · Nippon Laser Igakkaishi
  • Hiroshi Hayshi · Yukio Yasuda · Sadao Tsukada
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    ABSTRACT: We have investigated the parameters to improve the concequence of the treatment of port-wine stains (PWS) and develop a desirable procedure of laser irradiation.As for the wavelength, it has been found that the light of 585nm is superior to the light of 577nm in penetration into the depth of the skin of PWS.For the treatment of PWS of dark red and hypertrophic type, an equipment with a longer pulse duration may be more effective.The energy density was determined based on the result of test irradiation; the smallest energy that gave the best effect was used in the practical treatment as the optimal dose so as to prevent side effects.It is well known that the darker the color of the skin of the patient, the lower the transmittance of the laser beam and the worse the therapeutic effect. When we treated the PWS patients who had dark skin, skin abrasion was performed first and then irradiation was done during the stage of hypopigmentation following the epithelization, so that desirable concequence was obtained as the result of the increased transmittance of the laser beam.
    No preview · Article · Jan 1990 · Nippon Laser Igakkaishi
  • Hiroshi Hayashi · Yukio Yasuda · Sadao Tsukada
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    ABSTRACT: Eighty-three cases of pigmented skin lesion were treated with ruby laser (Toshiba Model LRT-301 A) and the usefulness was investigated.1) In the cases of nevus spilus, the color faded readily after only a course of irradiation and the posttreatment inflammatory redness and pigmentation were very mild, no scar formation being observed. However, a tendency of recurrence was noted.2) In the cases of pigmented nevus, the color faded hardly after one course of irradiation and repeated additional irradiation was required.3) In the cases of Ota's nevus, the treatment was effective for brownish lesions by not necessarily effective for bluish lesions because side effects such as scar formation appeared in some cases.4) In the cases wich lesions are localized in epidermis (except nevus spilus), good therapeutic effect, was attained
    No preview · Article · Jan 1990 · Nippon Laser Igakkaishi

Publication Stats

207 Citations
42.30 Total Impact Points

Institutions

  • 1981-1994
    • Kanazawa Medical University
      • • Department of Plastic and Reconstructive Surgery
      • • Department of Nephrology
      • • Department of Otorhinolaryngology
      Kanazawa, Ishikawa, Japan