An autopsy case of spinal arteriovenous malformation (Foix-Alajouanine syndrome).

An autopsy case of spinal arteriovenous malformation (AVM) was reported. The patient was a 75-year-old male and his initial neurologic symptoms were paraplegia, paresthesia below the umbilical level and urination difficulty. Subsequently night delirium and parkinsonism also appeared. The clinical and pathological findings in this case are identical with those in the spinal AVM except for Parkinson's disease. In addition, the lateral funiculus of the spinal cord in the middle thoracic segment showed pallor: Under light microscopy, the funiculus was spongiform, with a thinner wall of the myelin sheath, enlargement of the axon and the perivascular infiltration of phagocytes without plasma exudation. The changes in the lateral funiculus seemed to indicate early congestive changes.</p

Novel prospective umbrella-type lung cancer registry study for clarifying clinical practice patterns: CS-Lung-003 study protocol

Introduction Conventional cancer registries are suitable for simple surveillance of cancer patients, including disease frequency and distribution, demographics, and prognosis; however, the collected data are inadequate to clarify comprehensively diverse clinical questions in daily practice. Methods We constructed an umbrella‐type lung cancer patient registry (CS‐Lung‐003) integrating multiple related prospective observational studies (linked studies) that reflect clinical questions about lung cancer treatment. The primary endpoint of this registry is to clarify daily clinical practice patterns in lung cancer treatment; a key inclusion criterion is pathologically diagnosed lung cancer. Under this registry, indispensable clinical items are detected in advance across all active linked studies and gathered prospectively and systematically to avoid excessive or insufficient data collection. Researchers are to input information mutually, irrespective of the relevance to each researcher's own study. Linked studies under the umbrella of the CS‐Lung‐003 registry will be updated annually with newly raised clinical questions; some linked studies will be newly created, while others will be deleted after the completion of the analysis. Enrollment began in July 2017. Discussion We successfully launched the umbrella‐type CS‐Lung‐003 registry. Under this single registry, researchers collaborate on patient registration and data provision for their own and other studies. Thus, the registry will produce results for multiple domains of study, providing answers to questions about lung cancer treatment raised by other researchers. Through such analysis of each linked study, this registry will contribute to the comprehensive elucidation of actual daily practice patterns in lung cancer treatment. Key points CS‐Lung‐003 registry directly integrates multiple linked studies created under the umbrella of this cancer registry to solve various clinical questions regarding daily practice patterns of lung cancer treatment

High-power scanning electron microscopy of senile plaques, neurofibrillary tangles, and Pick bodies

Senile plaques, neurofibrillary tangles, and Pick bodies were examined by modified scanning electron microscopy from a low-power to an ultra high-power range. The amyloid core of the typical plaques was found to be composed of radially arranged rod-shaped components, which were made up of dense aggregation of meandering moniliform amyloid filaments about 15 nm in diameter. Bands with a mesh-like structure were observed outside the crown around the core. The compact plaques were nearly identical to the core alone of the typical plaques. The primitive plaques as a whole were analogous to the mesh-like structure around the typical plaques, and they both contained aggregates of filaments closely resembling amyloid fibers. In neurofibrillary tangles, the flamed shape stretched straight to the peripheries, the globosed shaped formed vortices, and only bundles of parallel filaments were observed. PHFs that constituted these structures were 25-30 nm in diameter, and many appeared constricted to a diameter of about 15 nm by rotating 180° to the left at a cycle of 70-80 nm. In Pick bodies, filaments were interwoven and formed a mesh-like structure, numerous granules were attached the filaments. Some filaments were large, being 20-30 nm in diameter, others were thin, being about 15nm in diameter

Neuropathological study on neuronal swelling degeneration in the substantia nigra of Olivo-Ponto-Cerebellar Atrophy (OPCA)

In 6 out of 7 autopsy cases of olivopontocerebellar atrophy, we found characteristic features of neuronal swelling degeneration (abbr. NSD) in the nerve cell of the substantia nigra. NSD was classified into 4 types according to the microscopic features. The cell body of the type A NSD is much larger than the usual nerve cell, contains melanin granules, is round in shape and appears granular. This cell sometimes contains a shrunken nucleus, Marinesco body, Nissl granules and rest of melanin pigment, suggesting its origin in the degenerating melanin containing nerve cell. In type B NSD the periphery of the swollen cell body appears to be frosted glass with a Nissl Substance. A part of the type B NSD was suggested to have its origin in the nerve cell which has no melanin pigment. Type C NSD is round or irregular in shape and appears to be vacuolar, suggesting its origin in the dendritic process. Type D NSD is sharply bounded from the surrounding tissue and amorphous structures. Judging from its staining characteristics, its origin was suggested to be in the axon. The significance and pathogenesis of the NSD are discussed with special reference to its relation to glutamic acid