Incidental Germinoma of the Basal Ganglia : A Neuropathologic Study

Neuropathologic findings of a case of an incipient germinoma in the basal ganglia incidentally found in a twelve-year-old boy who died of an accidental head trauma are described. Germinoma cells, in groups or singly, infiltrated mainly into the anterior part of the lateral division of the globus pallidus, and also into the anterior limb of the internal capsule, putamen, nucleus basalis of Meynert, anterior commissure, and the head of the caudate nucleus of the left cerebral hemisphere. Fundamental cerebral structures were well preserved. Tumor cells were positively stained for placental alkaline phosphatase by the PAP method, and could easily be discriminated from remaining nerve cells

Medical Devices for Parkinson’s Disease

Background: Pharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease. Methods: We first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices. Results: Our review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark. Conclusion: Invasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these

Neuropathologic Studies of Acute Multiple Sclerosis Mimicking Acute Encephalitis

Neuropathologic findings of acute multiple sclerosis mimicking acute encephalitis were described. The patient was a 42-year-old man with acute febrile encephalitic symptoms and signs such as high fever, unconsciousness and convulsive seizures, and a monophasic course of 18 days duration. Pathologically, numerous inflammatory demyelinating lesions were scattered mainly in the cerebral and cerebellar white matter, the internal capsules, the putamen, the brainstem and the optic nerves. In particular, the demyelinating lesions of the brainstem were extensive and confluent, whereas those in the right occipital lobe were small and perivenous, reminiscent of acute disseminated encephalomyelitis. Axons in these demyelinating lesions were well preserved, with a considerable number of macrophages and partial proliferation of protoplasmic astrocytes. There were no demyelinating lesions of concentric sclerosis type, which may occur in cases with acute multiple sclerosis. Pathological features in this case were typical of acute multiple sclerosis despite the symptoms and signs mimicking acute encephalitis and a clinical course of only 18 days duration

Cranial geometry in patients with dystonia and Parkinson’s disease

Abnormal skull shape has been reported in brain disorders. However, no studies have investigated cranial geometry in neurodegenerative disorders. This study aimed to evaluate the cranial geometry of patients with dystonia or Parkinson's disease (PD). Cranial computed tomography images of 36 patients each with idiopathic dystonia (IDYS), PD, and chronic subdural hematoma (CSDH) were analyzed. Those with IDYS had a significantly higher occipital index (OI) than those with CSDH (p = 0.014). When cephalic index (CI) was divided into the normal and abnormal groups, there was a significant difference between those with IDYS and CSDH (p = 0.000, α = 0.017) and between PD and CSDH (p = 0.031, α = 0.033). The age of onset was significantly correlated with the CI of IDYS (τ = − 0.282, p = 0.016). The Burke–Fahn–Marsden Dystonia Rating Scale motor score (BFMDRS-M) showed a significant correlation with OI in IDYS (τ = 0.372, p = 0.002). The cranial geometry of patients with IDYS was significantly different from that of patients with CSDH. There was a significant correlation between age of onset and CI, as well as between BFMDRS-M and OI, suggesting that short heads in the growth phase and skull balance might be related to the genesis of dystonia and its effect on motor symptoms

N-アセチルラクトサミン・キトビオースのアノマー位活性化および部分保護

糖鎖合成における従来法より効果的な新規ブロック合成法の確立のため､近年酵素合成可能となった二糖(N-アセチルラクトサミン､キトビオース)を用いて､アノマー位の活性化および部分保護について検討を行った結果､グリコシド化反応においてビリジニウム-p-トルエンスルホナート(PPTS)が2-アミノ糖で一般に用いられる酸触媒よりも効果的であることが判明した｡講演番号：3 A1 1

全脳型Creutzfeldt-Jakob病の1剖検例 : 特にその眼球病変について

1年7か月の経過をとり,臨床的に全脳型Creutzfeld-Jakob病と考えられていた症例を剖検した.脳は重量が695gで,び漫性に萎縮していた.眼球には肉眼的には変化はなかった.病理組織学的には大脳,小脳皮質,基底核,視床などに海綿状態,神経細胞の変性と脱落,原形質性アストロサイトの増殖,脂肪顆粒細胞の出現を認めた.大脳白質から中脳被蓋,橋にかけては広範に変性し,原形質性アストロサイトの増殖,脂肪顆粒細胞の出現を認めた.網膜では周辺網膜の外顆粒層に細胞脱落と空胞化,外網状層の変性,神経節細胞の変性と脱落,神経線維層の粗鬆化がみられた.本例の白質病変は皮質と同様の基質の変化,アストロサイトの増殖,脂肪顆粒細胞の出現などがみられたことより一次性変化と思われた.網膜の細胞脱落,空胞化,基質の粗鬆化なども大脳の変化と同様と思われ,網膜病変は一次性変化と考えられた.A case of the panencephalopathic type of Creutzfeldt-Jakob disease was reported. The patient was a 59-year-old female, who was admitted in July 1982 because of gait disturbance, hallucination, left hemiparesis and Gegenhalten of the left upper extremity. In September 1982 she developed akinetic mutism which lasted until her terminal stage. She died in February 1984 after a course of one year and seven months. The brain weighed 695 g and showed diffuse atrophy. Microscopically, there was marked atrophy and loss of neurons, and proliferations of protoplasmic astrocytes throughout the cerebral and cerebellar cortex, basal ganglia and thalamus. The cerebral white matter, tegmentum of the midbrain, pons, optic nerves, optic chiasm and optic tracts showed diffuse destruction of myelins and axons with fat granule cells and astrocytic proliferations. Loss of the outer nuclear layer of the retina was more prominent in the peripheral area than in the central area. The outer plexiform layer showed a remarkable vacuolization especially in the posterior region. Retinal ganglion cells showed degenerative changes and occasional loss. In this case, white matter involvements and ocular lesions were thought to be the primary degenerative changes of Creutzfeldt-Jakob disease