LUIS HENRIQUE ISHIDA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Practical Tips for Performing a Microvascular Anterolateral Thigh Flap(2012) ISHIDA, Luiz Carlos; ISHIDA, Luis Henrique
- Reply: Myotomy of the Levator Labii Superioris Muscle and Lip Repositioning: A Combined Approach for the Correction of Gummy Smile(2011) ISHIDA, Luis Henrique; ALONSO, Nivaldo; ISHIDA, Luiz C.; FERRIERA, Marcus Castro
- INTERNAL MAMMARY PERFORATOR VESSELS AS RECIPIENT SITE FOR MICROSURGICAL BREAST RECONSTRUCTION: A COMPARATIVE HISTOMORPHOMETRIC ANALYSIS AND INCIDENCE OF DEGENERATIVE VASCULAR CHANGES(2014) MUNHOZ, Alexandre Mendonca; ISHIDA, Luis H.; MONTAG, Eduardo; SAITO, Fabio L.; MENDES, Marcio; ALVES, Helio; GEMPERLI, RolfBackgroundIn microsurgical breast reconstruction, an adequate selection of recipient vessels is crucial for a successful outcome. Although the internal mammary (IM) vessels offer an attractive option, the internal mammary perforator (IMP) vessels are becoming a reliable alternative. The purpose of this study is to investigate the external diameters, lumen area, and atherosclerotic lesions changes of the IMP, IM, and deep inferior epigastric (DIE) vessels through quantitative and qualitative histomorphometric analysis. MethodsNinety-six vessels of bilateral IM, IMP, and DIE vessels from 16 fresh female cadavers were evaluated. Mean age was 54.065.7 years. External diameters, lumen area, and degenerative changes of the tunica intimae and media were analyzed by qualitative histomorphometric analysis. ResultsSeventy-one vessels (20 IM, 31 IMP, and 20 DIE vessels) were included in the final histological analysis. A statistically lower external diameters and lumen area were presented by the IMP. The DIE vessels showed a lower incidence (10%) of moderate and severe intimal layer degenerative changes (P=0.0589). The IMP and DIE vessels showed a lower incidence (9.4 and 25%, respectively) of major media layer degenerative changes (P=0.0001). No major arterial degenerative lesions were observed in the IMP arteries. ConclusionAlthough the IMP external diameters and lumen area were lower than the IM, the results of this study indicated that the tunica media layer in the IMP is less damaged than the other recipient vessels. The results of the comparative histological study permitted to describe additional advantages and disadvantages of using IMP as a recipient vessel for free flap breast reconstruction. (c) 2013 Wiley Periodicals, Inc. Microsurgery 34:217-223, 2014.
- A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients(2012) ALVES, Helio R. N.; ISHIDA, Luis C.; ISHIDA, Luis H.; BESTEIRO, Julio M.; GEMPERLI, Rolf; FARIA, Jose C. M.; FERREIRA, Marcus C.The supraclavicular island flap has been widely used in head and neck reconstruction, providing an alternative to the traditional techniques like regional or free flaps, mainly because of its thin skin island tissue and reliable vascularity. Head and neck patients who require large reconstructions usually present poor clinical and healing conditions. An early experience using this flap for late-stage head and neck tumour treatment is reported. Forty-seven supraclavicular artery flaps were used to treat head and neck oncologic defects after cutaneous, intraoral and pharyngeal tumour resections. Dissection time, complications, donor and reconstructed area outcomes were assessed. The mean time for harvesting the flaps was 50 min by the senior author. All donor sites were closed primarily. Three cases of laryngopharyngectomy reconstruction developed a small controlled (salivary) leak that was resolved with conservative measures. Small or no strictures were detected on radiologic swallowing examinations and all patients regained normal swallowing function. Five patients developed donor site dehiscence. These wounds were treated with regular dressing until healing was complete. There were four distal flap necroses in this series. These necroses were debrided and closed primarily. The supraclavicular flap is pliable for head and neck oncologic reconstruction in late-stage patients. High-risk patients and modified radical neck dissection are not contraindications for its use. The absence of the need to isolate the pedicle offers quick and reliable harvesting. The arc of rotation on the base of the neck provides adequate length for pharyngeal, oral lining and to reconstruct the middle and superior third of the face.
- Análise morfométrica do lábio superior e da ação do envelhecimento(2013) LONGO, MARCO VINICIUS LOSSO; ISHIDA, LUIS HENRIQUE; FORTES, FERNANDO SARTOR GUIMARÃES; KASAI, KIRIL ENDO; ISHIDA, LUIS CARLOS; ALONSO, NIVALDO; FERREIRA, MARCUS CASTROABSTRACT Background: A pleasant smile depends on harmonious relationships between the teeth, gums, and lips. The present study measured upper lip changes related to ageing using a morphometric analysis. Methods: Fortysix Caucasian women at least 15 years of age were selected and divided into four groups: 15 - 30 years old, 31 - 45 years old, 46 - 60 years old, and > 60 years old. Frontal photographs with closed lips and parted lips were taken. The following measurements were performed: upper lip height, upper vermilion height in parted and closed lips positions, and exposure of the central upper incisors in the relaxed position. Results: Upper lip height increased with age. The average upper lip height in the closed lips position was 13.75 mm in the youngest age-range (15 - 30 years old). The upper lip height gradually increased with age until reaching an average of 19.24 mm was observed in the > 60 years old group. The opposite result was observed in upper vermilion height, which decreased with increasing age. The average vermilion height in the parted lips position was 7.09 mm in the youngest age-range (15-30 years old) and decreased to 4.58 mm in the oldest group (> 60 years old). Teeth exposure decreased with age. The average upper teeth exposure was 3.55 mm in the youngest group and decreased to 0.40 mm in the oldest group. Conclusion: The upper lip height increases, while the upper vermilion height and exposure of the upper teeth decrease with age.
- Analysis of the Strength of the Abdominal Fascia in Different Sutures Used in Abdominoplasties(2011) ISHIDA, Luis Henrique; GEMPERLI, Rolf; LONGO, Marco Vinicius Losso; ALVES, Helio Ricardo Nogueira; SILVA, Pedro Henrique Quintino da; ISHIDA, Luis Carlos; FERREIRA, Marcus CastroProtrusion of the abdominal wall secondary to abdominoplasty may occur in patients with weakness of the aponeurotic structures. The anterior layer of the rectus abdominis muscle consists of fibers that are transverse rather than vertical. Based on this anatomical feature, vertical sutures are suggested for the correction of diastasis recti, since they include a greater amount of fascial fibers and thus would be more resistant to tensile strength than horizontal ones. The anterior layers of the rectus abdominis muscles of 15 fresh cadavers were dissected. Two vertical lines were marked on each side of the linea alba, corresponding to the site where plication is usually performed in abdominoplasties. Three abdominal levels were evaluated: the supraumbilical, umbilical, and infraumbilical levels. A simple suture was placed in the vertical direction in one group and in the horizontal direction in the other group, at each of the three levels previously described. These sutures were connected to a dynamometer, which was pulled medially toward the linea alba until rupture of the aponeurosis occurred. The mean strength required to rupture the aponeurotic structures in which the vertical sutures had been placed was greater than for the horizontal ones (p < 0.0001). The vertical suture of the rectus abdominis sheaths was stronger than the horizontal suture because of the more transversal arrangement of its aponeurotic fibers. Thus, routine use of the vertical suture in plications of the aponeurosis of the rectus abdominis muscles is suggested.
- Homozygous truncating PTPRF mutation causes athelia(2014) BORCK, Guntram; VRIES, Liat de; WU, Hsin-Jung; SMIRIN-YOSEF, Pola; NUERNBERG, Gudrun; LAGOVSKY, Irina; ISHIDA, Luis Henrique; THIERRY, Patrick; WIECZOREK, Dagmar; NUERNBERG, Peter; FOLEY, John; KUBISCH, Christian; BASEL-VANAGAITE, LinaAthelia is a very rare entity that is defined by the absence of the nipple-areola complex. It can affect either sex and is mostly part of syndromes including other congenital or ectodermal anomalies, such as limb-mammary syndrome, scalp-ear-nipple syndrome, or ectodermal dysplasias. Here, we report on three children from two branches of an extended consanguineous Israeli Arab family, a girl and two boys, who presented with a spectrum of nipple anomalies ranging from unilateral hypothelia to bilateral athelia but no other consistently associated anomalies except a characteristic eyebrow shape. Using homozygosity mapping after single nucleotide polymorphism (SNP) array genotyping and candidate gene sequencing we identified a homozygous frameshift mutation in PTPRF as the likely cause of nipple anomalies in this family. PTPRF encodes a receptor-type protein phosphatase that localizes to adherens junctions and may be involved in the regulation of epithelial cell-cell contacts, peptide growth factor signaling, and the canonical Wnt pathway. Together with previous reports on female mutant Ptprf mice, which have a lactation defect, and disruption of one allele of PTPRF by a balanced translocation in a woman with amastia, our results indicate a key role for PTPRF in the development of the nipple-areola region.
- Nasal Hump Treatment With Cartilaginous Push-Down and Preservation of the Bony Cap(2020) ISHIDA, Luiz Carlos; ISHIDA, Jorge; ISHIDA, Luis Henrique; TARTARE, Adriane; FERNANDES, Rafaela Katerine; GEMPERLI, RolfBackground: Classic nasal hump reduction based on partial resection of the cartilage and bones in the nose may lead to dorsum deformities such as an inverted-V deformity, irregularities, and an open roof. Techniques that preserve the nasal dorsum (namely the push-down and let-down) avoid these problems, but may not always be indicated for very large, broad, or deviated noses, whereas cartilaginous push-down is also indicated for large and deviated humps. Because only the cartilaginous portion of the hump is preserved in the cartilaginous push-down, a rough area may remain where the bony portion is resected. Objectives: The aim of this study was to develop a variation of the cartilaginous push-down technique which includes a bony cap to preserve the smoothness of the keystone area during nasal hump treatment. Methods: Forty-eight consecutive patients with indication for nasal hump treatment who underwent cartilaginous push-down procedures with bony cap preservation between August 2018 and October 2019 were studied. Results: We observed related complications in 2 patients (4.2%); in 1 patient (2.1%) the bony cap was lost during the rasping of the nasal bones and the surgery was altered to utilize only the cartilaginous push-down. Another patient (2.1%) experienced a mild hump recurrence during the early weeks following the procedure. All of the remaining patients had their nasal humps treated adequately. Conclusions: The nasal hump was adequately corrected in most of the study patients (95.8%). Preserving the bony cap while performing the cartilaginous push-down may prevent complications related to the osseous resection of the keystone area.