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Katsumi Harimaya

Publications and source records attributed to Katsumi Harimaya.

11 recordsLinked to original sources

Adventitial cystic disease of the popliteal vein: report of a case.

Adventitial cystic disease (ACD), also known as cystic mucoid or myxomatous degeneration, is a rare vascular disease seen mainly in arteries. It is very unusual for these cystic masses to develop in a vein. We report the case of a 56-year-old woman with leg swelling caused by ACD arising in the popliteal vein. The swelling appeared after a long period of standing. Magnetic resonance imaging (MRI) showed a popliteal cystic mass and venography showed disrupted venous flow. We resected the cyst wall without venous reconstruction, after which venous blood flow normalized and her symptoms subsided. To our knowledge, this is only the third documented case of ACD arising in the popliteal vein. A misdiagnosis could easily have been made, since the mass was not obvious on physical examination and the only symptom was intermittent swelling. Thus, it is important to be aware of ACD as a possible diagnosis when examining patients with a swelling in the leg.

Adult↗

Dedifferentiated chondrosarcoma with leukocytosis and elevation of serum G-CSF. A case report.

BACKGROUND: G-CSF is known to function as a hematopoietic growth factor and it is known to be responsible for leukocytosis. G-CSF-producing tumors associated with leukocytosis include various types of malignancies. CASE PRESENTATION: We report the case of a 72-year-old man with dedifferentiated chondrosarcoma characterized by dedifferentiated components of malignant fibrous histiocytoma- or osteosarcoma-like features in addition to conventional chondrosarcoma, arising from his pelvic bone. After hemipelvectomy, when local recurrence and metastasis were identified, leukocytosis appeared and an elevated level of serum granulocyte-colony-stimulating factor (G-CSF) was also recognized. The patient died of multiple organ failure 2 months after surgery. Autopsy specimens showed that the histological specimens of the recurrence and metastasis were dedifferentiated components, without any conventional chondrosarcoma components. G-CSF was expressed only in the dedifferentiated components, not in the chondrosarcoma components, immunohistochemically. CONCLUSION: This is the first report of chondrosarcoma, or any other primary bone tumor, with leukocytosis, probably stimulated by tumor-produced G-CSF from the dedifferentiated components.

Journal Article↗

Traumatic atlanto-occipital dislocation with atlantoaxial subluxation.

STUDY DESIGN: This is a case report of a patient who survived traumatic atlanto-occipital dislocation with atlantoaxial subluxation. OBJECTIVE: To describe the useful points of 3-dimensional computerized tomography (CT) and magnetic resonance imaging (MRI) for an evaluation of atlanto-occipital dislocation. SUMMARY OF BACKGROUND DATA: Atlanto-occipital dislocation is a severe ligamentous injury that usually results in either a fatal outcome or severe neurologic deficit. To our knowledge, no patient who has survived atlanto-occipital dislocation with atlantoaxial subluxation has yet been reported. METHODS: Three-dimensional CT was performed to confirm the diagnosis of atlanto-occipital dislocation and precisely evaluate the magnitude of displacement. MRI clearly showed a disruption of the ligamentous structures, which play a role as the primary stabilizers of the cranium on the cervical spine. RESULTS: As soon as the patient's general condition improved, the posterior spinal fusion with internal fixation was performed to maintain the stability of cervical spine. A significant degree of motor function was regained within 2 years after injury. CONCLUSIONS: In this case, the diagnosis was accurately confirmed, and the cervical spine was evaluated in detail using both 3-dimensional CT and MRI as a reliable examination for atlanto-occipital dislocation.

Adult↗

Repetitive tensile stress to rat caudal vertebrae inducing cartilage formation in the spinal ligaments: a possible role of mechanical stress in the development of ossification of the spinal ligaments.

OBJECT: Mechanical stress has been considered one of the important factors in ossification of the spinal ligaments. According to previous clinical and in vitro studies, the accumulation of tensile stress to these ligaments may be responsible for ligament ossification. To elucidate the relationship between such mechanical stress and the development of ossification of the spinal ligaments, the authors established an animal experimental model in which the in vivo response of the spinal ligaments to direct repetitive tensile loading could be observed. METHODS: The caudal vertebrae of adult Wistar rats were studied. After creating a novel stimulating apparatus, cyclic tensile force was loaded to rat caudal spinal ligaments at 10 N in 600 to 1800 cycles per day for up to 2 weeks. The morphological responses were then evaluated histologically and immunohistochemically. After the loadings, ectopic cartilaginous formations surrounded by proliferating round cells were observed near the insertion of the spinal ligaments. Several areas of the cartilaginous tissue were accompanied by woven bone. Bone morphogenetic protein-2 expression was clearly observed in the cytoplasm of the proliferating round cells. The histological features of the rat spinal ligaments induced by the tensile loadings resembled those of spinal ligament ossification observed in humans. CONCLUSIONS: The findings obtained in the present study strongly suggest that repetitive tensile stress to the spinal ligaments is one of the important causes of ligament ossification in the spine.

Animals↗

Atlantoaxial instability in neck retraction and protrusion positions in patients with rheumatoid arthritis.

STUDY DESIGN: Radiographic analysis of the upper cervical spine was performed in patients with rheumatoid arthritis who had C1-C2 instability. OBJECTIVE: To assess whether neck retraction or neck protrusion movements can cause C1-C2 subluxation in patients with C1-C2 instability. SUMMARY OF BACKGROUND DATA: Cervical protrusion is the position where the head is maximally translated anteriorly with zero sagittal rotation, and this position has been shown to produce maximal C1-C2 extension. In contrast, cervical retraction is the position where the head is maximally translated posteriorly, and this position produces maximal C1-C2 flexion. To date, there have been no studies evaluating the effects of these two positions on C1-C2 status in patients with C1-C2 instability. METHODS: Twenty-four patients with rheumatoid arthritis who showed an atlantodental interval of at least 5 mm during neck flexion were evaluated in this study. These patients were instructed to actively hold the neck in protrusion and retraction positions, as well as in flexion and extension positions. Lateral cervical radiographs were taken to measure the C1-C2 angle and the atlantodental interval in the sagittal plane in each position. RESULTS: Retraction produced both maximal C1-C2 flexion and anterior C1-C2 subluxation, of a degree just the same as that produced by cervical flexion. Protrusion reversely produced maximal C1-C2 extension. However, 9 of 24 patients exhibited C1-C2 subluxation even in this protrusion position, in marked contrast to the cervical extension position in which only 2 of 24 patients showed C1-C2 subluxation. The patients who showed C1-C2 subluxation in the protrusion position tended to have more severe C1-C2 instability and less capacity for C1-C2 extension than the other patients who achieved a reduction of C1-C2 in the protrusion position. CONCLUSION: In patients with C1-C2 instability, not only cervical flexion but also cervical retraction constantly led to both maximal C1-C2 flexion and subluxation. In some patients with severe C1-C2 instability, protrusion also resulted in C1-C2 subluxation, even though the C1-C2 was maximally extended.

Adult↗

Primitive neuroectodermal tumor and extraskeletal Ewing sarcoma arising primarily around the spinal column: report of four cases and a review of the literature.

STUDY DESIGN: Report of four cases and a review of the literature. OBJECTIVES: To study the clinical features and prognosis of primitive neuroectodermal tumor or extraskeletal Ewing sarcoma arising around the spinal column. SUMMARY OF BACKGROUND DATA: Primitive neuroectodermal tumor or extraskeletal Ewing sarcoma that originates around the spinal column is very rare, and its prognosis is very poor. METHODS: Four patients were diagnosed and underwent treatment. RESULTS: Although all the patients received high-dose chemotherapy with or without radiotherapy after surgery, three patients died of the disease. Only one patient who received en bloc resection of the tumor combined with multiagent chemotherapy followed by high-dose chemotherapy with peripheral blood stem cell transplantation remains alive and continues to be disease free. CONCLUSION: The prognosis of the patients with primitive neuroectodermal tumor or extraskeletal Ewing sarcoma around the spinal column is very poor. Multiagent chemotherapy combined with en bloc resection and radiation therapy is the preferred treatment for patients with primitive neuroectodermal tumor or extraskeletal Ewing sarcoma around the spinal column.

Adolescent↗

Ossification of the posterior atlantoaxial membrane. Case report.

The authors report a case of ossification of the posterior atlantoaxial membrane that led to the development of cervical myelopathy. Computerized tomography and magnetic resonance imaging were helpful in establishing the diagnosis, and decompressive laminectomy may be an appropriate intervention.

Atlanto-Axial Joint↗

Vascular compression caused by solitary osteochondroma: useful diagnostic methods of magnetic resonance angiography and Doppler ultrasonography.

Osteochondroma is a common benign bone tumor that sometimes causes vascular complications when the lesion is situated near the knee. Venous complications are seen less frequently. We report two cases of solitary osteochondroma that arose in the distal femur. The patients were an 11-year-old boy and a 16-year-old boy, both of whom were suffering from bone protuberance and lower leg swelling due to congestion. In both patients, magnetic resonance imaging (MRI) revealed dilated popliteal veins at a site distal from the tumors or superficial veins. MR angiography (MRA) showed compressed popliteal arteries, and Doppler ultrasonography revealed weaker blood flow in the dorsalis pedis arteries in the lower leg with the tumor than in the other lower leg. The former patient complained of pain due to swelling in the lower leg, and for this reason the patient underwent resection of the tumor. After resection, both the swelling and the pain were decreased, and Doppler ultrasonography also revealed normal blood flow in the artery. The latter patient had swelling, but no pain, in the lower leg, and accordingly this patient has been followed carefully without resection, since there is always the possibility of irreversible vascular damage caused by osteochondroma, such as arterial or venous occlusion. We present two patients with osteochondroma, both of whom suffered from swelling of the lower leg due to venous compression by the tumor. In both cases, MRI and MRA were useful to show the presence of vascular compression. Doppler ultrasonography could also reveal the blood flow disturbance objectively, even in current osteochondroma cases in which there were no arterial symptoms.

Adolescent↗

Solitary lymphangioma of the femur. A case report.

Lymphangioma of the bone is a benign lesion, characterized by newly formed lymph vessels. It usually occurs in a diffuse manner or as multiple lesions. Solitary lymphangioma of the bone is an extremely rare condition. We herein describe a case of solitary lymphangioma of the femur in a 55-year-old woman who presented with knee pain. Radiographs showed an eccentric osteolytic lesion in the distal femur. This is the first reported case of solitary lymphangioma of the bone occurring in the femur.

Biopsy, Needle↗

Traumatic neuroma of the anterior cervical nerve root with no subjective episode of trauma. Report of four cases.

The authors report four cases of traumatic neuroma in the cervical nerve root in patients with no history of trauma. In one case the patient presented with intractable pain in the left upper extremity and motor paresis of the left shoulder, and in another case the patient suffered neuropathic pain in the left forearm. In both cases, magnetic resonance (MR) imaging revealed an intradural extramedullary mass lesion in the ipsilateral cervical nerve root; these MR imaging signals were similar to the intensity of the spinal cord. Intraoperatively, fusiform enlargement of the anterior cervical nerve root was detected in the subarachnoid space. Histological examination showed a meandering change of axons accompanied by mild axonal swelling and a thin myelin sheath, which are consistent with the typical pathological features of traumatic neuroma. Postoperatively, pain resolved in both cases. The authors also investigated two traumatic neuromas of the anterior cervical nerve root in autopsy cases in which there was no history of trauma and no significant neurological signs suggestive of traumatic neuroma. The authors conclude that traumatic neuroma of the anterior cervical nerve root may develop following an unnoticed minor brachial plexus injury at birth or a forgotten traction injury of the upper extremity in childhood, and the lesion may be accompanied by various case-specific clinical features.

Adult↗