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Biomedical subjects

T Kitahara

Publications and source records attributed to T Kitahara.

At least 73 records · Page 4Linked to original sources
PubMed1998

An implication of protein phosphatase 2A-beta in the rat flocculus for lesion-induced vestibular plasticity.

The differential display method was applied to identify genes, the expression of which is up-regulated in the cerebellar flocculus after unilateral labyrinthectomy (UL). Total RNA from sham-operated and labyrinthectomized rat flocculi was isolated, amplified by polymerase chain reaction (PCR) using a single arbitrary primer and separated by electrophoresis on a polyacrylamide gel. PCR products in amounts significantly higher in samples from labyrinthectomized animals than in those from controls were cut out of the gel and sequenced. One of the cDNA fragments showed 100% nucleotide sequence identity to the rat protein phosphatase 2A (PP2A)-beta catalytic subunit mRNA. In situ hybridization histochemistry and Northern blot analysis showed that PP2A-beta mRNA expression was intensely localized to the floccular Purkinje cell layer and up-regulated with a maximum increase within 2 days after UL. In labyrinthectomized rats, UL-induced nystagmus gradually disappeared within 3 days after UL. However, in animals with continuous floccular infusion of okadaic acid, a potent inhibitor of PP2A, UL-induced nystagmus lasted significantly longer. All these findings suggest that up-regulation of PP2A-beta mRNA in floccular Purkinje cells after UL is involved in lesion-induced vestibular plasticity. So far, various kinds of neural plasticity-associated molecules have been investigated mainly by slice in vitro studies. This paper indicates that differential display is the feasible molecular biological in vivo method for an investigation about the mechanism of neural plasticity.

Animals↗
PubMed1998

Temporal lobe epilepsy associated with cerebral venous angioma--case report.

A 21-year-old male presented with temporal lobe epilepsy associated with a venous angioma in the ipsilateral frontal lobe, presenting as intractable complex partial seizures. Neuroimaging showed a cerebral venous angioma in the right dorsolateral and opercular frontal lobe, and atrophy of the right hippocampus. As the ictal electroencephalogram (EEG) obtained with subdural electrodes indicated spike discharges initiating from the right mesial temporal lobe, temporal lobectomy was performed. The patient was seizure-free after the operation. Patients with epilepsy who have a cerebral venous angioma require precise analysis of the seizure pattern and an ictal EEG because of cerebral venous angioma may be associated with an another epileptogenic lesion which is surgically treatable.

Adult↗
PubMed1998

[Clinical features in patients with delayed endolymphatic hydrops].

We report clinical features in patients with delayed endolymphatic hydrops (DEH) with juvenile unilateral deafness. Among 23 patients with DEH, 15 cases were diagnosed as ipsilateral DEH and 8 cases as contralateral DEH. The distribution of onset age showed two peaks at ages of < 30 years and > 40 years. In 80% of the ipsilateral DEH cases, the onset of episodic vertigo was at younger ages. On the other hand, in 75% of the contralateral DEH cases, the onset of fluctuation hearing loss of the contralateral ear was at older ages. Ispilateral DEH and Meniere's disease may show different pathophysiologies. The incidence of dominant negative summating potential in the better-hearing ear was 20% in the ispilateral DEH cases and 60% in the contralateral DEH cases. It is suggested that endolymphatic hydrops is in the better-hearing ear of contralateral DEH.

Adult↗
PubMed1998

[Identification of vestibular compensation-associated molecules by means of differential display].

The differential display method was used to identify gene expression which is altered in the cerebellar flocculus after unilateral labyrinthectomy (UL). Total RNA from flocculi of sham-operated and labyrinthectomized rats was isolated, amplified by PCR using arbitrary primer sets and separated by electrophoresis on a polyacrylamide gel. PCR products, whose amounts were significantly different in samples from labyrinthectomized animals and those from controls, were cut out of the gel and sequenced. One of the up-regulated products was the rat protein phosphatase 2A beta catalytic subunit mRNA and one of the down-regulated products was the rat glutamate receptor delta-2 subunit mRNA. Histochemical examination of in situ hybridization showed that those molecules were intensively localized in the Purkinje cell layer. In labyrinthectomized rats, UL-induced nystagmus gradually disappeared within 3 days after UL. These findings suggest that changes in expression of those molecules in the floccular Purkinje cells after UL is involved in vestibular compensation. So far various kinds of neural plasticity-associated molecules have been investigated, mainly by slice-in vitro studies. This study indicates that differential display is a feasible molecular biological in vivo method for investigation of the mechanism of neural plasticity.

Animals↗
PubMed1998

Molecular mechanisms of vestibular compensation in the central vestibular system--review.

Vestibular compensation consists of two stages: the inhibition of the contralesional medial vestibular nucleus (contra-MVe) activities at the acute stage after unilateral labyrinthectomy (UL) and the recovery and maintenance of the ipsilesional MVe (ipsi-MVe) spontaneous activities at the chronic stage after UL. In this paper, we reviewed molecular mechanisms of vestibular compensation in the central vestibular system using several morphological and pharmacological approaches in rats. Based on our examinations, we propose the following hypotheses: i) at the acute stage after UL, the activated neurons in the ipsi-MVe project their axons into the flocculus to inhibit the contra-MVe neurons via the NMDA receptor, nitric oxide (NO) and/or GABA-mediated signalling, resulting in the restoration of balance between intervestibular nuclear activities. ii) At the chronic stage after UL, the flocculus depresses the inhibitory effects on the ipsi-MVe neurons via protein phosphatase 2A (PP2A) beta, protein kinase C (PKC) and glutamate receptor (GluR) delta-2, to help the recovery and maintenance of ipsi-MVe activities.

Animals↗
PubMed1998

[The role of neuropaediatrician in the comprehensive management of children with cerebral palsy].

The child with cerebral palsy becomes the adult with cerebral palsy. In Japan early detections and treatments of CP have enthusiastically brought into practice over the last twenty years. But cerebral palsy could not be cured. Children/adults with CP should be provided comprehensive treatments and cares so that they can perform their daily activities and fulfil their social roles expected during their lifetime. There are two concepts needed to provide comprehensive management of CP. The first is a medical model that assesses CP in the following manner: etiology-pathology-manifestation. The other is a disability model based on three seperate categories suggested by WHO: impairment-disability-handicap. Keeping these in mind, total effective approaches to children/adults with CP were discussed. Neuropaediatricians are asked to play important roles which contain epidemiologic activities, early detections, and medical treatments. They should refer clients and their families to related professionals if necessary and have also knowledges of assisstive equipments to enrich their lives.

Activities of Daily Living↗
PubMed1997

Antibiotic diffusion pathways in the outer membrane of Pseudomonas aeruginosa.

We investigated the effect of a temperature shift from 37 degrees C to 17 degrees C on the steady-state diffusion rate of imipenem and cephalothin by evaluating periplasmic drug concentrations in intact cells of Pseudomonas aeruginosa, which overexpresses the extended spectrum beta-lactamase. We found that the ratio of periplasmic imipenem concentration at 17 degrees C relative to that of 37 degrees C was 1.03+/-0.1, whereas that of cephalothin was 0.43+/- 0.09. Accumulation rates of cell-associated tetracycline and fluoroquinolone at 17 degrees C were roughly 1/16 and 1/8, respectively, compared with that at 37 degrees C. We concluded from these data that cephalothin and possibly most other antibiotics excepting carbapenems cross the outer membrane of P. aeruginosa mainly by dissolving in the lipid phase but probably not passing through the porin channel. This may explain why the outer membrane of P. aeruginosa is a tight barrier against the penetration of antibiotics.

Anti-Bacterial Agents↗
PubMed1997

Cellular features of differentiation in the nail.

Biochemical analysis indicated that the human nail plate contains two distinct types of keratin (skin-type and hair-type keratins), and several population of keratinocytes are thought to be associated with development of the nail. To elucidate the nature of the differentiation occurring in nail development, we examined the patterns of molecular markers relevant to the course of differentiation in the skin and hair in the nail matrix as well as in cultured nail cells. The nail matrix was characterized by the mutually exclusive localization of skin-type and hair-type markers, while in the apical matrix the localization of two groups of keratins partially overlapped. Double-label immunofluorescence showed the existence of unusual cells coexpressing both keratins, thereby indicating that the nail matrix consists of skin-type and hair-type and additionally intermediate-type differentiating cells. The cultured cells taken from the ventral matrix which develop under hair-type differentiation in vivo were found to express skin-type along with hair-type keratins, suggesting alteration of the pathway of differentiation in vitro. The cellular diversification as seen in in vitro cultured cells provides further insight into nail differentiation which is related to the multiple patterns of keratin expression that generate in the nail matrix.

Animals↗
PubMed1997

Changes in nitric oxide synthase-like immunoreactivities in unipolar brush cells in the rat cerebellar flocculus after unilateral labyrinthectomy.

To elucidate the role of nitric oxide (NO)-mediated signaling in vestibular compensation, we examined effects of unilateral labyrinthectomy (UL) on the neuronal isoform of NO synthase (NOS) expression in the rat central vestibular system using immunohistochemical techniques. After UL, a substantial number of NOS-like immunoreactive (-LIR) neurons were observed in the granule cell layer in bilateral flocculi, and these neurons were determined to be unipolar brush cells (UB cells) by their unique morphology and location. NOS-LIR UB cells appeared by 12 h with a maximum increase in number 24 h after UL, and then gradually disappeared in accordance with the development of vestibular compensation. Continuous floccular infusion of N(omega)-nitro-L-arginine methyl ester (L-NAME), an inhibitor of NOS, or 2-phenyl-4,4,5,5-tetramethyl-1-oxyl-3-oxide (PTIO), an inhibitor of NO, caused more severe vestibulo-ocular deficits at the initial stage after UL and slightly delayed the recovery from these symptoms. All these findings suggest that up-regulation of NO production in floccular UB cells facilitates vestibular compensation, especially at the initial stage after UL.

Animals↗
PubMed1997

Reduction of radiation-induced xerostomia in nasopharyngeal carcinoma using CT simulation with laser patient marking and three-field irradiation technique.

PURPOSE: Tumor control and reduction of postirradiation xerostomia in patients with nasopharyngeal carcinoma (NPC) using the three-field irradiation technique based on the CT-based simulation with laser patient marking was investigated. METHODS AND MATERIALS: Seventy-eight patients with NPC were consecutively treated between 1983 and 1993. In 33 patients treated before 1987, target volume was determined using a conventional x-ray simulator with a reference of CT images, and the primary site was treated by the conventional parallel-opposed two-field technique (Group I). In 45 patients treated from 1987, target volume was determined using a CT simulator slice by slice, the treatment field was projected onto the patient's skin by a laser beam projector mounted on a C-arm, and the primary site was irradiated by a three-fields (anterior and bilateral) technique (Group II). In Group II, the shape of each field was determined using a beam's eye view to reduce the dose to the bilateral parotid glands. The three-field technique reduced the dose to the superficial lobe of parotid gland to about two-thirds of the dose given by the two-field technique. Radiation-induced xerostomia was evaluated by clinical symptoms and radioisotope sialography. RESULTS: The 5-year survival rate and disease-free survival rate were 46.6 and 31.2% in Group I, and 46.8 and 46.5% in Group II. A large variation in the volume of parotid glands were demonstrated, ranging from 9 cm3 to 61 cm3 among patients treated with CT simulation. Forty percent of the patients in Group II showed no or mild xerostomia, whereas all of the patients in Group I showed moderate to severe xerostomia (p < 0.01). The radioisotope sialography study showed that the mean secretion ratio by acid stimulation was improved from 3.8% in the Group I to 15.2% in the Group II (p < 0.01). CONCLUSIONS: CT simulation was useful to determine the size and shape of each field to reduce the dose to the parotid gland, of which size varies largely among individual patients. The three-field technique based on CT simulation with laser patient markings is suggested to result in superior complication-free survival in terms of salivary dysfunction than did the conventional two-field technique with x-ray simulatior for NPC.

Adolescent↗
PubMed1997

Analysis of long-term treatment of intracranial germinoma.

PURPOSE: To determine an appropriate treatment policy for intracranial germinoma. METHODS AND MATERIALS: From 1976 to 1992, 51 patients with germinoma (18 with pathologically verified germinoma and 33 diagnosed as having germinoma by neuroimagings) were treated by radiation therapy. Various radiation doses and treatment fields were used. RESULTS: The 10-year cause-specific survival rate for pathologically verified and unverified germinoma was 100% and 96%, respectively. Relapses were noted in four patients, three of whom died from the disease. Two of the four patients with a tumor larger than 4 cm in gross diameter experienced relapse. Two relapses occurred in a nonirradiated spinal canal and two occurred in the irradiation area treated by 25 Gy in 10 fractions and 30 Gy in 20 fractions. No relapse was noted in patients in whom the whole ventricle field was determined precisely using three-dimensional treatment planning. Five patients who were followed at an outpatient clinic experienced significant late neurocognitive dysfunction, which set in after radiotherapy. CONCLUSION: After pathological confirmation, 40 Gy whole-ventricle irradiation using precise three-dimensional treatment planning is appropriate as a standard treatment for most intracranial germinoma.

Adolescent↗
PubMed1997

Reevaluation of postoperative radiotherapy for thoracic esophageal carcinoma.

PURPOSE: To reevaluate postoperative radiotherapy for thoracic esophageal carcinoma. METHODS AND MATERIALS: Reviewed were the outcome of 89 patients who underwent esophagectomy with systematic dissection of regional lymph nodes between 1988 and 1993. Of the 89 patients, 19 underwent no adjuvant treatment, 22 underwent adjuvant chemotherapy alone, and 48 underwent postoperative radiotherapy. Twelve of the 48 also underwent adjuvant chemotherapy. RESULTS: All patients who experienced local-regional recurrence had lymph node metastases at the time of surgery. The actuarial local-regional control rate at 2-year of follow-up was 94% for patients with lymph node metastases at the time of surgery who underwent postoperative radiotherapy alone or plus chemotherapy, and 74% for those who underwent adjuvant chemotherapy alone. The local-regional control rate was significantly better for those who had undergone postoperative radiotherapy (p < 0.01). CONCLUSIONS: Postoperative radiotherapy still plays an important role as adjuvant treatment.

Adult↗
PubMed1997

Role of the flocculus in the development of vestibular compensation: immunohistochemical studies with retrograde tracing and flocculectomy using Fos expression as a marker in the rat brainstem.

After unilateral labyrinthectomy in rats, Fos-like immunoreactive neurons appeared in the ipsilateral medial vestibular nucleus, contralateral prepositus hypoglossal nucleus and contralateral inferior olive beta subnucleus. and thereafter gradually disappeared in accordance with the development of vestibular compensation. This finding indicated that the activation of these nuclei is the initial event of vestibular compensation. In the present study, retrograde tracing experiments revealed that these Fos-like immunoreactive neurons project a proportion of their axons to the vestibulocerebellum (uvula-nodulus, flocculus). Before vestibular compensation was accomplished, right, left or bilateral flocculectomy was performed in right-labyrinthectomized rats. All these treatments caused reappearance of unilateral labyrinthectomy-induced behavioral deficits and Fos expression in the left medial vestibular nucleus and right prepositus hypoglossal nucleus. Since floccular efferents are GABAergic, these results indicate that the neurons in which Fos expression was detected by flocculectomy had been inhibited after unilateral labyrinthectomy by floccular Purkinje neurons and that disinhibition of these neurons induced by flocculectomy caused decompensation. Based on our present findings, we propose a hypothesis that the bilateral flocculus serves the restoration of balance between intervestibular nuclear activities to induce vestibular compensation after unilateral labyrinthectomy.

Animals↗
PubMed1997

P2 aneurysm approached via the temporal horn: technical case report.

OBJECTIVE AND IMPORTANCE: We report the use of a transcortical transventricular approach to a P2 aneurysm, which was located near the choroidal fissure, protruded into the temporal horn, and was considered to be too difficult to approach by the conventional subtemporal route. CLINICAL PRESENTATION: An 81-year-old woman suddenly developed severe headache with vomiting and subsequently lost consciousness. Computed tomographic scans revealed a diffuse intraventricular hemorrhage and subarachnoid hemorrhage. Cerebral angiography disclosed a saccular aneurysm in the right P2 segment. INTERVENTION: On the 16th day after admission, successful neck clipping was easily performed through the temporal horn via the inferior temporal gyrus. The postoperative course was uneventful. CONCLUSION: This special approach may be preferable in such cases, because it protects the brain from the detrimental effects of strong temporal retraction and provides a wider working space.

Aged↗
PubMed1997

Neurotropic pyrimidine heterocyclic compounds. II. Effects of novel neurotropic pyrimidine derivatives on astrocytic morphological differentiation.

Astrocytes play an important role in supporting nerve regeneration after brain injuries. In this study, the effects of novel neurotropic synthesized pyrimidine compounds on astrocytic morphological differentiation were examined. Treatment of protoplasmic cultured astrocytes with 2-piperidino-5,6-dihydro-7-methyl-6-oxo(7 H)pyrrolo[2,3-d]pyrimidine maleate (MS-430) and the related compounds caused astrocytic process formation in 60 min. The morphology of MS-430-treated cells was similar to that of dibutyryl cAMP (DBcAMP)-treated cells. The astrocytic process formation by MS-430 was observed within 60 min and the maximum effect was obtained at the drug concentration of 0.5-1.0 mM. Rhodamine-phalloidin staining showed that astrocytic cytoskeletal actin was reorganized by MS-430 and DBcAMP. MS-430 did not increase cAMP accumulation in cultured astrocytes. These results suggest that the neurotropic pyrimidines induced astrocytic morphological differentiation through a cAMP-independent mechanism.

Animals↗
PubMed1997

[Clinical features and utricular dysfunction in patients with benign paroxysmal positional vertigo].

We report the clinical features in patients with benign paroxysmal positional vertigo (BPPV), who met the following criteria; (1) a history of brief episodes of positional vertigo, and (2) a characteristic torsional paroxysmal positional nystagmus that was observed visually. The mean age of onset was 55 years. There was no sex predominance. In most patients, positional vertigo disappeared within 2 months. We then used the eccentric rotatory test to examine the patients otolithic function. In the eccentric rotatory test, a patient is rotated around an axis located behind his head (eccentric rotation, ECR). We have demonstrated that the enhancement of vestibulo-ocular reflex (VOR) gain in ECR can be used as an index of the utricular function. Enhancement of VOR gain was observed in ECR to the lower ear in positional vertigo, but not to the uppermost ear. The findings suggest an imbalance in utricular function in patients with BPPV. Otoconia dislodged from the deranged utricle may be a source of canalolithiasis/cupulolithiasis.

Adult↗
PubMed1997

[Motor cortex stimulation therapy in patients with thalamic pain].

Seven patients with thalamic pain were treated by electrical stimulation of the motor cortex. Patients ranged from 55 to 71 years of age. There were six men and one woman. Causes of thalamic pain were thalamic infarction in 2 patients and thalamic hemorrhage in five. Six patients had intractable pain associated with dysesthesia in the upper and lower limb (upper limb dominant). One patient had intractable pain in the face contralateral to the lesion. Magnetic resonance images (MRI) were performed in 5 patients and showed the deposit of hemosiderin in the internal capsule, posterolateral nucleus and pulvinar. Electrodes were placed on the motor cortex epidurally in seven patients. Electrodes were implanted permanently in six patients and removed in one patient after an unsatisfactory result of test stimulation. Motor cortex stimulation provided satisfactory pain relief in all six patients for a month after the beginning of stimulation, however, by the time three months had passed, pain relief had become gradually unsatisfactory in five patients. We compared pain relief between 10 Hz and 100 Hz of stimulus rate in four patients and observed that all patients complained of fatigue in the upper extremity at the 100 Hz of stimulus rate, though no differences in pain relief was obtained according to which of these two stimulus rates were used. We concluded that motor cortex stimulation brought about pain inhibition in patients with thalamic pain, but pain control tended to become less gradual within several months after the beginning of stimulation.

Aged↗