Comparison of Spinous Process-Splitting Laminectomy versus Conventional Laminectomy for Lumbar Spinal Stenosis

Masashi Uehara,Jun Takahashi,Hiroyuki Hashidate,Keijiro Mukaiyama,Shugo Kuraishi,Masayuki Shimizu,Shota Ikegami,Toshimasa Futatsugi,Nobuhide Ogihara,Hiroki Hirabayashi,Hiroyuki Kato 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.6

Study Design: Seventy-five patients who had been treated for lumbar spinal stenosis (LSS) were reviewed retrospectively. Purpose: Invasion into the paravertebral muscle can cause major problems after laminectomy for LSS. To address these problems, we performed spinous process-splitting laminectomy. We present a comparative study of decompression of LSS using 2 approaches. Overview of Literature: There are no other study has investigated the lumbar spinal instability after spinous process-splitting laminectomy. Methods: This study included 75 patients who underwent laminectomy for the treatment of LSS and who were observed through follow-ups for more than 2 years. Fifty-five patients underwent spinous process-splitting laminectomy (splitting group) and 20 patients underwent conventional laminectomy (conventional group). We evaluated the clinical and radiographic results of each surgical procedure. Results: Japanese Orthopaedic Association score improved significantly in both groups two years postoperatively. The following values were all significantly lower, as shown with p -values, in the splitting group compared to the conventional group: average operating time (p =0.002), postoperative C-reactive protein level (p =0.006), the mean postoperative number of days until returning to normal body temperature (p =0.047), and the mean change in angulation 2 years postoperatively (p =0.007). The adjacent segment degeneration occurred in 6 patients (10.9%) in the splitting group and 11 patients (55.0%) in the conventional group. Conclusions: In this study, the spinous process-splitting laminectomy was shown to be less invasive and more stable for patients with LSS, compared to the conventional laminectomy.

Mid-Term Results of Computer-Assisted Cervical Pedicle Screw Fixation

Masashi Uehara,Jun Takahashi,Keijiro Mukaiyama,Shugo Kuraishi,Masayuki Shimizu,Shota Ikegami,Toshimasa Futatsugi,Nobuhide Ogihara,Hiroyuki Hashidate,Hiroki Hirabayashi,Hiroyuki Kato 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.6

Study Design: A retrospective study. Purpose: The present study aimed to evaluate mid-term results of cervical pedicle screw (CPS) fixation for cervical instability. Overview of Literature: CPS fixation has widely used in the treatment of cervical spinal instability from various causes; however, there are few reports on mid-term surgical results of CPS fixation. Methods: Record of 19 patients who underwent cervical and/or upper thoracic (C2–T1) pedicle screw fixation for cervical instability was reviewed. The mean observation period was 90.2 months. Evaluated items included Japanese Orthopaedic Association (JOA) score and C2–7 lordotic angle before surgery and at 5 years after surgery. Postoperative computerized tomography was used to determine the accuracy of screw placement. Visual analog scale (VAS) for neck pain and radiological evidence of adjacent segment degeneration (ASD) at the 5-year follow-up were also evaluated. Results: Mean JOA score was significantly improved from 9.0 points before surgery to 12.8 at 5 years after surgery (p =0.001). The C2–7 lordotic angle of the neutral position improved from 6.4° to 7.8° at 5 years after surgery, but this was not significant. The major perforation rate was 5.0%. There were no clinically significant complications such as vertebral artery injury, spinal cord injury, or nerve root injury caused by any screw perforation. Mean VAS for neck pain was 49.4 at 5 years after surgery. The rate of ASD was 21.1%. Conclusions: Our mid-term results showed that CPS fixation was useful for treating cervical instability. Severe complications were prevented with the assistance of a computed tomography-based navigation system.

Mini Open Foraminotomy for Cervical Radiculopathy: A Comparison of Large Tubular and TrimLine Retractors

Masashi Uehara,Jun Takahashi,Shugo Kuraishi,Masayuki Shimizu,Shota Ikegami,Toshimasa Futatsugi,Kaoru Aoki,Keijiro Mukaiyama,Nobuhide Ogihara,Hiroyuki Hashidate,Hiroki Hirabayashi,Hiroyuki Kato 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.4

Study Design: Retrospective chart review. Purpose: A comparison of mini open foraminotomy (MOF) for cervical radiculopathy using either large tubular (LT) or TrimLine (TL) retractors. Overview of Literature: Posterior foraminotomy relieves compression of the cervical nerve root in radiculopathy patients. However, invasion of the paravertebral muscle may cause major problems in these patients. To address these problems, we performed MOF. Methods: Twenty cervical radiculopathy patients (16 male and 4 female) who underwent MOF between May 2004 and August 2011 were assigned to LT and TL groups. Each group contained 10 subjects. Surgical and clinical outcomes were compared. Results: The average operating time in the TL group was significantly shorter than that in the LT group. The final follow-up mean neck disability indices significantly improved compared to the preoperative values (LT group, 12.0±7.8 vs. 28.0±9.4; TL group, 6.0±5.9 vs. 21.9±10). The final follow-up neck pain visual analog scale (VAS) scores also decreased significantly from the preoperative of 8.0±1.5 and 2.5±2.5 to the final follow-up values of 2.2±2.2 and 1.0±2.5 in the LT and TL groups, respectively. The recovery rate for the neck pain VAS score was 70.0±31.9 in the LT group and 87.0±32.0 in the TL group, thus suggesting no significant difference between the two groups. Conclusions: MOF with the TL retractor is an easy and safe procedure. Furthermore, the use of the TL retractor allows for a minimally invasive and effective surgical treatment of cervical radiculopathy patients.

Myxopapillary Ependymoma of the Cauda Equina in a 5-Year-Old Boy

Masashi Uehara,Jun Takahashi,Keijiro Mukaiyama,Shugo Kuraishi,Masayuki Shimizu,Shota Ikegami,Toshimasa Futatsugi,Kenji Sano,Kazuhiro Hongo,Hiroyuki Kato 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.6

Myxopapillary ependymoma in childhood typically occurs in the central nervous system. There are few surgical cases of myxopapillary ependymoma of the cauda equina in children. We report a case of myxopapillary ependymoma of the cauda equina in a 5-yearold boy, who presented with leg pain and abnormal gait. Subtotal resection surgery was performed. Following the subtotal tumor resection, follow-up magnetic resonance imaging evaluation showed a recurrent tumor. As a result, we performed a second subtotal tumor resection and followed with postoperative radiation therapy. No further evidence of the disease has been noted elsewhere in the patient in over ten years of follow-up. Myxopapillary ependymoma of the cauda equina in a young boy was improved by subtotal tumor resection and postoperative radiation therapy.

DNA mismatch repair-related protein loss as a prognostic factor in endometrial cancers

Masafumi Kato,Masashi Takano,Morikazu Miyamoto,Naoki Sasaki,Tomoko Goto,Hitoshi Tsuda,Kenichi Furuya 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.1

Objective: Recent investigations have revealed DNA mismatch repair (MMR) gene mutations are closely related with carcinogenesis of endometrial cancer; however the impact of MMR protein expression on prognosis is not determined. Correlations between MMR-related protein expression and clinicopathological factors of endometrial cancers are analyzed in the present study. Methods: A total of 191 endometrial cancer tissues treated between 1990 and 2007 in our hospital were enrolled. Immunoreactions for MSH2, MLH1, MSH6, and PMS2 on tissue microarray specimens and clinicopathological features were analyzed retrospectively. Results: Seventy-six cases (40%) had at least one immunohistochemical alteration in MMR proteins (MMR-deficient group). There were statistically significant differences of histology, International Federation of Gynecology and Obstetrics (FIGO) stage, and histological grade between MMR-deficient group and the other cases (MMR-retained group). Response rate of first-line chemotherapy in evaluable cases was slightly higher in MMR-deficient cases (67% vs. 44%, p=0.34). MMR-deficient cases had significantly better progression-free and overall survival (OS) compared with MMR-retained cases. Multivariate analysis revealed MMR status was an independent prognostic factor for OS in endometrial cancers. Conclusion: MMR-related proteins expression was identified as an independent prognostic factor for OS, suggesting that MMR was a key biomarker for further investigations of endometrial cancers.

Allelopathy of pine litter: Delivery of allelopathic substances into forest floor

Fukiko Kimura,Masashi Sato,Hisashi Kato-Noguchi 한국식물학회 2015 Journal of Plant Biology Vol.58 No.1

Red pine (Pinus densiflora Sieb. et Zucc.) forest forms sparse forest floor where herbaceous plants do not grow well. Allelopathic chemical interaction was speculated to play an important role in the formation of the forest floor. However, only several phenolic acids and their related compounds have been isolated from the forest floor. Those compounds are universal in many plants and cannot distinguish such strong allelopathic activity of red pine from other plants. The present research investigates whether red pine litter contains some potential allelopathic substances other than phenolics. Aqueous methanol extracts of red pine litter inhibited the growth of cress (Lepidium sativum) and Digitaria sanguinalis L., and increasing the extract concentration increased the inhibition. The extract was then purified by several chromatographies and biological activities of all separated fractions were determined. Two main inhibitory substances were finally isolated and their chemical structures were determined by spectral data as 9α,13β- epidioxyabeit-8(14)en-18-oic acid and abscisic acid-β-Dglucopyranosyl ester. These compounds may be synthesized in pine plants and delivered into the forest floor by defoliation of the needles. Their inhibitory activity on the germination and the growth may play an important role in the formation of the sparse forest floors.

Effect of Arrangement of Input Gates on Logic Switching Characteristics of Nanodot Array Device

JO, Mingu,KATO, Yuki,ARITA, Masashi,ONO, Yukinori,FUJIWARA, Akira,INOKAWA, Hiroshi,TAKAHASHI, Yasuo,CHOI, Jung-Bum 'Institute of Electronics, Information and Communi 2012 IEICE transactions on electronics Vol.95 No.5

Association of a polymorphism of BTN2A1 with dyslipidemia in East Asian populations

FUJIMAKI, TETSUO,KATO, KIMIHIKO,OGURI, MITSUTOSHI,YOHIDA, TETSURO,HORIBE, HIDEKI,YOKOI, KIYOSHI,WATANABE, SACHIRO,SATOH, KEI,AOYAGI, YUKITOSHI,TANAKA, MASASHI,YOSHIDA, HIROTO,SHINKAI, SHOJI,NOZAWA, YO Spandidos Publications 2011 Experimental and therapeutic medicine Vol.2 No.4

Clear cell histology as a poor prognostic factor for advanced epithelial ovarian cancer: a single institutional case series through central pathologic review

Morikazu Miyamoto,Masashi Takano,Tomoko Goto,Masafumi Kato,Naoki Sasaki,Hitoshi Tsuda,Kenichi Furuya 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.1

Objective: Compared with serous adenocarcinoma (SAC), clear cell carcinoma (CCC) often shows chemo-resistance, which would potentially lead to a poor prognosis. On the other hand, there have been arguments over prognoses of CCC and SAC disease. In the present study, multivariate analysis to compare prognosis of CCC patients with that of SAC was aimed for the patients selected from central pathologic review. Methods: Between 1984 and 2009, a total of 500 ovarian cancer patients were treated at our university hospital. Among them,111 patients with CCC and 199 patients with SAC were identified through central pathological review. Overall survival and progression-free survival were compared using Kaplan-Meier method, and prognostic factors were investigated by multiple regression analyses. Results: Median age was 52 years for CCC and 55 years for SAC (p=0.03). The ratio of stage I patients were significantly higher in CCC compared with SAC (55% vs. 13%, p<0.01). Among evaluable cases, response rate was significantly lower in CCC than that in SAC (32% vs. 78%, p<0.01). No significant differences of progression-free survival and overall survival were observed in stage I patients; however, prognoses of CCC were significantly poorer than those of SAC in advanced-stage disease. In stage II-IV patients, not only residual tumors and clinical stages, but also clear cell histology were identified as predictors for poor prognosis. Conclusion: Clear cell histology was identified as a prognostic factor for advanced-stage ovarian cancers. Histologic subtypes should be considered in further clinical studies, especially for advanced epithelial ovarian cancers.

Ten-Year Results of Reconstruction for Rheumatoid Cervical Spine Lesions and Occurrence Factor of Subaxial Subluxation

Daisuke Kurogochi,Jun Takahashi,Masashi Uehara,Shota Ikegami,Shugo Kuraishi,Toshimasa Futatsugi,Hiroki Oba,Takashi Takizawa,Ryo Munakata,Terue Hatakenaka,Michihiko Koseki,Hiroyuki Kato 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.5

Study Design: Retrospective chart review. Purpose: This study evaluated long-term surgical outcomes of computer-assisted reconstruction using transarticular or cervical pedicle screws for cervical spine lesions caused by advanced rheumatoid arthritis (RA). Overview of Literature: We routinely employ C1–C2 transarticular and cervical pedicle screw instrumentation to reconstruct advanced and unstable RA cervical lesions. However, few reports are available on the long-term results of surgical reconstruction for rheumatoid cervical disorders, particularly regarding cervical pedicle screw fixation. Methods: Six subjects (all female) with RA cervical lesions who underwent atlantoaxial or occipitocervical fixation and were followed for at least 10 years were retrospectively studied. A frameless, stereotactic, optoelectronic, computed tomography-based image guidance system was used for correct screw placement. Variables including the Japanese Orthopaedic Association score, EuroQol, Ranawat value, and C2–C7 angle before and 2, 5, and 10 years after surgery were assessed along with the occurrence of subaxial subluxation (SAS). Results: Mean age at initial surgery was 58.2±7 years (range, 51–68 years), and mean follow-up period was 141±11 months (range, 122–153 months). Lesions included atlantoaxial subluxation (AAS, n=2) and AAS+vertical subluxation (n=4). Mean C2–C7 lordotic angle before and 2, 5, and 10 years after surgery was 20.1°±6.1°, 21.0°±4.0°, 18.8°±4.7°, and 17.8°±5.3°, respectively. SAS did not occur in cases maintaining the C2–C7 lordotic angle. In two cases where the C2–C7 lordotic angle declined from 5 years postoperatively, SAS occurred at the C2–C3 level in one and at the C4–C5 level in the other, both of which required reoperation. Conclusions: Patients with rheumatoid cervical lesions who undergo atlantoaxial or occipitocervical fixation using C1–C2 transarticular or pedicle screws carry a risk of SAS for up to 10 years postoperatively, which may require reoperation.