Are you Yukio Mikami?

Claim your profile

Publications (2)4.12 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: A prospective clinical study. To elucidate the histomorphological features and clinical significance of the epidural membrane (EM) in the cervical spine based on operative and histological findings. The anatomical features of the EM have been mostly discussed on the basis of cadaver studies in the whole spine. However, the histomorphological features and clinical significance of the EM in the cervical spine based on operative findings have never been reported. Eighty-seven patients with cervical spondylotic myelopathy who had undergone an expansive open-door laminoplasty under microscopy were evaluated with a more than 2-year follow-up period. The most damaged spinal segment was determined in each patient from the preoperative neurological and image findings along with the remaining symptoms at follow-up. The morphological features of the EM were observed and recorded in each patient during decompression. For histology, specimens of common and remarkable types of the EM obtained from 16 patients were examined. The age at surgery averaged 64.5 years; there were 58 men and 29 women. With regard to the most damaged spinal segment, there were 14 cases at the C3-C4 level, 37 at the C4-C5 level, 32 at the C5-C6 level, and 4 at the C6-C7 level. The EM was an adipo-fibro-vascular tissue with various histomorphologies, blending with the periradicular sheath. Some EMs showed notable findings: obstructing dural tube expansion (13 cases, 14.9%), compressing a nerve root or disturbing its mobility (4 cases, 4.6%), and the combined type (1 case, 1.1%). All of them were located at approximately the most damaged spinal segment. In addition, some EMs had interesting histological features, such as harboring many small arteries, calcified debris, and metaplastic bone fragments. The EM can develop into remarkable structures with spondylosis and aging in patients with cervical spondylotic myelopathy, affecting surgical outcomes as well as successful decompression procedures. A sound understanding of the histomorphological features of the EM is required to obtain satisfactory surgical outcomes in the limited field afforded by minimally invasive surgery.
    Spine 05/2012; 37(19):E1182-8. DOI:10.1097/BRS.0b013e31825fcfb5 · 2.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Resection for a mass in the proximal thigh was performed on a 57-year-old woman, the diagnosis of which was extraskeletal osteosarcoma. In pathological findings, tumor cells gradually decreased from the central area of the mass composed of spindle cell sarcoma and were replaced by fibrocollagenous tissue with no sarcoma cells. CD8(+), T-cell-restricted intracellular antigen-1 (TIA-1)(+), granzyme B(+) T lymphocytes appeared to infiltrate the mass lesion, so that we hypothesize that the immunological system was likely to be involved via T lymphocytes in triggering spontaneous regression in this case. One of the most unusual phenomena in cancer biology is the spontaneous regression of a tumor. Here, we report on the first case of extraskeletal osteosarcoma characterized by partial spontaneous regression of the primary lesion.
    Anticancer research 12/2009; 29(12):5197-201. · 1.83 Impact Factor