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Yoichi Katayama

Publications and source records attributed to Yoichi Katayama.

66 records · Page 4Linked to original sources

Dual-floor burr hole adjusted to burr-hole ring and cap for implantation of stimulation electrodes. Technical note.

Using a new perforator, the authors have developed a new dual-floor burr-hole method for use in deep brain stimulation therapy. The modification is called "dual-floor" because the usual 15-mm-diameter burr hole, which is located centrally and reaches the dura mater, is surrounded by a 4-mm-wide rim that is also planed downward by the new perforator to a depth of 4 mm. This dual-floor burr hole is adjusted to fit the burr-hole ring and cap that are are supplied by the electrode manufacturer. Such a method eliminates bulging of the scalp just over the burr-hole ring and cap. In addition, it is helpful for securing a tight fixation between the burr-hole ring and the skull.

Electric Stimulation Therapy↗

Evaluation of time-dependent spread of tissue damage in experimental spinal cord injury by killed-end evoked potential: effect of high-dose methylprednisolone.

OBJECT: Histopathological studies on spinal cord injury (SCI) have demonstrated time-dependent spread of tissue damage during the initial several hours postinjury. When the long tract within the spinal cord is stimulated, a large monophasic positivity occurs at the injury site. This type of potential, termed the killed-end evoked potential (KEEP), indicates that a nerve impulse approaches but does not pass beyond the injury site. The authors tested the hypothesis that the damage spread can be evaluated as a progressive shift of the KEEP on a real-time basis. The effect of high-dose methylprednisolone sodium succinate (MPSS) on the spread of tissue damage was also examined by this methodology. METHODS: The KEEP was recorded using an electrode array placed on the spinal cord at the T-10 level in cats. This electrode array consisted of multiple 0.2-mm-diameter electrodes, each separated by 0.5 mm. Spinal cord injury was induced using a vascular clip (65 g pinching pressure for 30 seconds). The midline posterior surface of the spinal cord was stimulated bipolarly at the C-7 level by applying a single pulse at supramaximal intensity. During the initial period of 6 hours postinjury, the localization of the largest KEEP shifted progressively up to 2.5 mm rostral from the injury site. The amplitude of the KEEP recorded at the injury site decreased to 55 to 70% and became slightly shortened in latency as the localization of the largest KEEP shifted rostrally. These findings imply that the injury site KEEP represents the volume-conducted potential of the largest KEEP at the site of the conduction block. It moved away from the injury site in association with the damage spread, and this was confirmed histopathologically. A decrease in amplitude of KEEP at the injury site appeared to be the most sensitive measure of the damage spread, because the amplitude of the volume-conducted KEEP is inversely proportional to the square of the distance between the recording site and site of conduction block. Administered immediately after SCI, MPSS clearly inhibited these events, especially within 30 minutes postinjury. CONCLUSIONS: The KEEP enables sequential evaluation to be made of the time-dependent spread of tissue damage in SCI in the same animal. It is, therefore, useful for detecting the effect of therapeutic interventions and for determining the therapeutic time window. The efficiency of MPSS to inhibit the spread of damaged tissue appeared to be maximized when it was administered within the initial 30-minute period postinjury.

Animals↗

[Improvement of host-immunity by adjuvant therapy with juzen-taiho-to for patients with brain tumors].

T cell subset, natural killer (NK) cell activity and tumor necrosis factor alpha (TNF-alpha) productivity of lymphocytes in the peripheral blood were investigated in order to study host-immunity before and after administration of Juzentaiho-to (TJ-48) with or without Interferon-beta (INF-beta) for 29 patients with brain tumors (15 cases of gliomas and 14 cases of non-glial tumors). "A" group was given TJ-48 (7.5 g/day, p.o.) with INF-beta 300 million IU/1-2 weeks after initial treatment, and "B" group was treated by only TJ-48. % values of helper T cells (CD4+, CD45RA-), cytotoxic T cells (CD8+, 11b-), suppressor T cells (CD8+ +. 11b+) and NK activity were calculated with two color flowcytometry before and at 1 month, 2 months and 3 months after the administration of TJ-48. TNF-alpha productivity of lymphocytes was examined by the ELISA method at the same time. Suppressor T cells decreased significantly after 2 months following administration of JT-48 in 16 of 17 cases in both A and B group. After administration of TJ-48, helper T cells tended to increase slightly, but cytotoxic T cells and NK activity did not change. TNF-alpha productivity was measured in 8 cases of gliomas and increased to levels higher than they were before administration of TJ-48 in all of the cases which were examined more than 2 months after treatment. Adjuvant therapy with TJ-48 in both A and B group improved the host-immunity of the patients with brain tumors. It was concluded that it was useful as an assistant treatment for brain tumors.

Aged↗

[Therapeutic efficacy and prognostic factors in diffuse astrocytomas].

Diffuse astrocytomas are slowly growing tumors with a relatively long overall survival. Considerable controversy exists as to the best therapeutic management for patients with such tumors. In the present study, we retrospectively analyzed a series of 64 patients with WHO grade II astrocytomas of the cerebral hemispheres. Gross total resection and interferon-beta therapy were significantly associated with both longer progression free survival (PFS) and overall survival (OS). Immediate postoperative radiation therapy did not prolong either the PFS or OS. The presence of promoter hypermethylation of the O6-methylguanine-DNA methyltransferase (MGMT) gene was an independent predictor of a shorter PFS. Our data suggest that radical surgery plus interferon-beta therapy may offer the best chance for long survival. Since the presence of MGMT methylation is a probable indication of an increased sensitivity to alkylating chemotherapeutic agents, determining the methylation status of MGMT could provide a potential basis for logical therapeutic intervention in identifying a subgroup of patients who could be candidates for early chemotherapy.

Adolescent↗

Prediction of clinical course of diffusely infiltrating astrocytomas from telomerase expression and quantitated activity level.

Telomerase, one of the reverse transcriptases that extend telomere length, has been suggested to facilitate tumorigenesis and tumor immortality. Little is yet known, however, concerning the clinical significance of telomerase expression in brain tumors. We found in the present study that telomerase expression may contribute to malignant progression and can be an important indicator of high grade diffusely infiltrating astrocytomas, and its quantitated activity level reflects their growth potential. Telomerase expression and its quantitated activity level are also a good predictor of clinical course as compared with other biological markers and clinical factors.

Adolescent↗

Effects of antioxidant, OPC-14117, on secondary cellular damage and behavioral deficits following cortical contusion in the rat.

In the present study, we examined the effects of OPC-14117, a superoxide radical scavenger, on the secondary cellular damage and cognitive dysfunction occurring in a rat model of cerebral contusion induced by a controlled cortical impact (CCI). Histological examinations revealed that the contusion necrosis volume reached 13.6+/-5.3 mm(3) in non-treated animals and declined to 1.9+/-0.6 mm(3) in OPC-14117-treated animals (P<0.01). The cell number of the CA3 region was 120.0+/-12.4 cells/mm in the normal controls, 73.6+/-9.9 cells/mm in the non-treated animals, and 111.2+/-10.2 cells/mm in the OPC-14117-treated animals, indicating that CCI-induced selective neuronal cell death in the CA3 region was attenuated by the OPC-14117 administration (P<0.01). The tissue osmolality, as determined with a vapor pressure osmometer, was 314.5+/-15.4 mmol/kg in the normal brain and increased to 426.0+/-20.1 mmol/kg at 12 h following CCI. The increase in tissue osmolality was significantly attenuated by OPC-14117 administration (P<0.01). The OPC-14117 administration also attenuated the CCI-induced cognitive deficits. The OPC-14117-treated animals showed a tendency to improve on the Morris water maze performance test. The impairment of the habituation of exploratory activity elicited by CCI was significantly attenuated by OPC-14117 administration (P<0.05). In conclusion, OPC-14117 may have a potential for decreasing secondary cellular damage due to traumatic brain injury since it is as efficacious as any other compound tested in this model.

Animals↗

An ultrastructural and immunohistochemical study of olfactory neuroepithelioma with rhabdomyoblasts.

A rare case of olfactory neuroepithelioma with rhabdomyoblasts in a 61-year-old man was investigated using electron microscopic and immunohistochemical methods. A large tumor enhanced by gadolinium-diethylenetriamine pentaacetic acid (DTPA) was demonstrated on magnetic resonance imaging (MRI), located within the anterior cranial fossa without bone destruction. The tumor mostly consisted of small cells with scant cytoplasm. Tubular rosettes were often found. Immunoreactivity for cytokeratin and epithelial membrane antigen (EMA) was strongly positive. Most of the tumor cells were shown to be positive for neuron-specific enolase (NSE) and vimentin and weakly positive for synaptophysin and S-100. Rhabdomyoblasts, which showed oval cells with abundant eosinophilic cytoplasm and a nucleus sometimes displaced toward the periphery of the cell body, were frequently intermingled with the tumor cells. The immunoreactivity for myoglobin was frequently positive in these oval cells. The MIB-1 index showed high values, of 20%-40%. About 10% of the tumor cells revealed positivity for p53 protein and vascular endothelial growth factor (VEGF). Ultra-structurally, numerous junctional complexes were observed between cell bodies and processes. The cell processes frequently contained numerous microtubules. There were sometimes numerous filaments with small aggregates of Z-band material and thick filament-ribosomal complexes in the oval cells. They were concluded to be consistent with rhabdomyoblasts on light microscopic and immunohistochemical findings.

Esthesioneuroblastoma, Olfactory↗

Growth control of C6 glioma in vivo by nerve growth factor.

Treatment with nerve growth factor (NGF) causes differentiation of rat C6 glioma cells and strongly inhibits their proliferation in vitro. This suggests that induction of NGF-mediated differentiation may provide a novel therapeutic approach to growth control of glial tumors. We examined the effects of NGF treatment on the growth potential of C6 glioma, which expressed NGF receptor in vivo. C6 glioma cells (1 x 10(6) cells/10 microl) were transplanted into the rat striatum. After 4 days, the animals were given successive injections of 100 ng NGF into the growing tumor at every 4 days (n = 10 rats). Controls were subjected to identical procedures with vehicle which did not contain NGF (n = 10 rats). At 14 days after transplantation, we evaluated the tumor volume, proliferative cell index (PCI) based on the MIB-1 immunoreactivity and enzyme activities related to energy metabolism by enzyme histochemistry. We found that the NGF treatment markedly reduced the tumor volume of the C6 glioma (34.00 +/- 8.47 mm3 to 7.22 +/- 4.92 mm3, p < 0.01). NGF treatment also decreased the PCI (33.34 +/- 9.57% to 3.85 +/- 3.56%, p < 0.01) with a negative correlation with tumor volume (r = 0.972, p < 0.01), and the hexokinase (HK) and glucose-6-phosphate dehydrogenase (G6PDH) activities (p < 0.01 and p < 0.01, respectively) which reflect the demand for nucleic acid synthesis for proliferation through the glycolytic and pentose phosphate pathways. The present results demonstrate for the first time that inhibition of tumor cell proliferation of C6 glioma by NGF occurs in vivo, probably through the NGF-mediated differentiation of C6 glioma cells which has been observed in in vitro studies.

Animals↗

Thalamic relay nucleus stimulation for relief of intractable pain. Clinical results and beta-endorphin immunoreactivity in the cerebrospinal fluid.

Deep brain stimulation (thalamic relay nucleus, periaqueductal gray and internal capsule) was applied to various cases of intractable pain, and the resulting degree of pain reduction and alteration in beta-endorphin immunoreactivity in the cerebrospinal fluid (CSF) were compared. The following results were obtained. (1) The studies on intractable pain revealed that the levels of beta-endorphin immunoreactivity in the CSF were lower than those in the control group. (2) Thalamic relay nucleus stimulation proved effective not only for deafferentiation pain, but also for somatogenic pain. No relationship was, however, noted between pain reduction and the rate of increase of beta-endorphin immunoreactivity in the CSF. (3) The incidence of stimulation tolerance following prolonged stimulation of the thalamic relay nucleus can be reduced to a minimum by administration of L-DOPA. It is concluded that the increase in beta-endorphin in the CSF is not the direct and major cause of pain reduction during treatment by thalamic relay nucleus stimulation. It may be assumed that neuronal facilitation on the monoaminergic descending pain inhibitory system plays a role in reducing pain.

Adult↗

Deep brain stimulation therapy for the vegetative state.

Twenty-one cases of a vegetative state (VS) caused by various kinds of brain damage were evaluated neurologically and electrophysiologically three months after brain injury. These cases were treated by deep brain stimulation (DBS) therapy, and followed up for over 10 years. The mesencephalic reticular formation was selected as a target in two cases, and the thalamic centre median-parafascicular (CM-pf) complex was selected as a target in the other 19 cases. Eight of the 21 patients emerged from the VS, and became able to obey verbal commands. However, they remained in a bedridden state except for one case. DBS therapy may be useful for allowing patients to emerge from a VS, if the candidates are selected according to appropriate neurophysiological criteria. A special neurorehabilitation system may be necessary for emergence from the bedridden state in the treatment of VS patients. Further, DBS therapy is expected to provide a useful method in minimally conscious state (MCS) patients to achieve consistent discernible behavioural evidence of consciousness, and emergence from the bedridden state.

Adult↗