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Biomedical subjects

H Ishino

Publications and source records attributed to H Ishino.

At least 19 recordsLinked to original sources

An autopsy case of PSP with astrocytic inclusions.

Argyrophilic glial cytoplasmic inclusions were observed in astrocytes (Astrocytic Inclusions) in a case of progressive supranuclear palsy (PSP). The inclusions were predominantly distributed in the lenticular nucleus and midbrain, but not in the cerebral cortex, white matter nor in the thalamus. When examined by double staining with Gallyas silver and GFAP, they resembled the neurofibrillary tangles (NFT) and were tau positive. The distribution of these inclusions was not related to that of NFT. These inclusions indicate that astrocytes were involved in the same pathological changes as NFT. Argyrophilic inclusions were also observed in oligodendroglias on Gallyas silver staining. They appeared coiled and located mainly in the cerebral and cerebellar white matter.

Astrocytes

An autopsy case of Alzheimer disease with myoclonus and periodic spikes on EEG.

This is a case of Alzheimer disease with myoclonus and periodic spikes on EEG. A 56-year-old man developed progressive dementia and, 3 years later, generalized convulsions. Eight years later, he showed myoclonus and periodic spikes on EEG. Cranial CT showed cortical atrophy and ventricular dilatation. He became apallic and died of pneumonia at the age of 65.9 years after the onset of the disease. The brain weighed 1,050 g. Neuropathologically, diffuse neuronal loss, abundant neurofibrillary tangles and senile plaques, particularly diffuse plaques, were found extensively in the cerebral cortex. The white matter was preserved. In the Ammon's horn, abundant neurofibrillary tangles and senile plaques were observed. Grumose degeneration of the cerebellar dentate nucleus, Kuru plaques or prions were not found. Numerous diffuse plaques of the cerebral cortex have rarely been reported in autopsy cases of Alzheimer disease with myoclonus and periodic spikes on EEG.

Alzheimer Disease

[A case of neuro-Behçet's disease with numerous hypertrophied and proliferated dendrites in the inferior olivary nucleus].

A 32-year-old man suffering from iritis, erythema, and recurrent oral aphthae showed signs of involvement of the central nervous system for 8 years before his death. Behçet disease was diagnosed. He showed neurologic symptoms, such as facial nerve palsy, gait disturbance, and pathological reflexes, and psychiatric symptoms, such as euphoria, disinhibition, and irritability. Characteristic neuropathologic findings were hypertrophy of the bilateral olivary nuclei with marked hypertrophy and proliferation of dendrites, which have been extremely rare in the reported autopsy cases of neuro-Behçet disease. Most changes were observed in the brainstem. Many microspongionecrotic foci were fused to from glial scars with marked lymphocytic perivascular infiltration. In addition, lesions were found throughout the spinal cord; degenerative changes were found in the lateral corticospinal tract, posterior colum (especially the fasciculus gracilis), and anterior and posterior spinocerebellar tracts. We believe, on the basis of the following neuropathologic findings, that the cause of the olivary pseudohypertrophy with dendritic hypertrophy and proliferation was a denervational process: (1) bilateral red nuclei were intact and (2) bilateral tegmental tracts had degenerated from the lower portion of the pons to the periphery of olivaly nuclei.

Behcet Syndrome

[Crossed aphasia in a dextral patient--a case of sensory aphasia due to a right hemispheric lesion].

An extremely rare case of sensory aphasia due to a right hemispheric lesion in a 61-year-old, right-handed male is reported. He manifested jargon aphasia, constructional apraxia and ideational apraxia after an operation for right temporo-parietal cerebral hemorrhage. Standard language test of aphasia (SLTA) administered 6 months after the onset revealed disturbance of verbal comprehension and repetition, fluent jargon with many paraphasias and paragraphias. The brain CT, MRI and IMP-SPECT disclosed right temporo-parietal and angular lesions. There are two other reported cases of right posterior lesion (Puels et al. 1982, Habibs et al. 1983) accompanied by symptoms similar to those in this case, e.g., jargon aphasia, paragraphia and apraxia, and in these cases as well the right deep hemispheric lesion encompassed Wernicke's area. It is suggested that the right and left brain functions are reversed in this patient, because the symptoms of the dominant hemisphere such as sensory aphasia, constructional apraxia, and ideational apraxia were associated with the lesion of the right hemisphere.

Aphasia

[An autopsy case of ataxic form of Creutzfeldt-Jakob disease].

An autopsy case of ataxic form of Creutzfeldt-Jakob disease (Brownell and Oppenheimer, 1965) was reported. The patient, a 71-year-old male, noticed ataxic gait at the beginning of June in 1988, and was admitted to the Hiroshima City Hospital for the neurological examination at the end of June. He showed ataxia of the left arm and legs and diplopia. Gradually he became delirious at night. On July 16, tremor-like involuntary movement of the left hand was noticed. On July 20, he became somnolent and doubly incontinent. Myoclonus and paratonic rigidity were also observed. The EEG showed periodic synchronous discharge on July 25. The brain CT and MRI were normal. He became apallic gradually and died on October 28. The duration of illness was 5 months. At autopsy, brain weighed 1000gr. Cerebral atrophy and slight enlargement of the ventricles were observed. The cerebellum was also slightly atrophic. Histologically, the destruction of the cerebral cortical layer, slight sieve-like spongy state of the neuropil, slight neuronal loss of the thalamus and sieve-like spongy state of the striatum were observed. The cerebellar lesion was the most severe, where granular cell loss and gliosis of the cortex were observed.

Aged

Genetic factors regulate the rise in blood pressure in F2 generation crossed between stroke-prone spontaneously hypertensive rats and Wistar-Kyoto rats.

1. There was no significant difference between the systolic blood pressure (SBP) of offspring derived from SHRSP mother and WKY father and the SBP of offspring derived from WKY mother and SHRSP father at the developing stage (5-13 weeks of age). 2. The degree of genetic determinations of SBP in stroke-prone spontaneously hypertensive rat (SHRSP) at 5, 7, 10 and 13 weeks of age, determined by genetic crosses between SHRSP and WKY, was 73.9, 70.8, 50.2 and 55.3% respectively. 3. Significant correlations between SBP at 5 and 7 weeks, 7 and 10 weeks, 10 and 13 weeks, also at 5 and 13 weeks of age in F2 generation crossed between SHRSP and WKY were observed. SBP falling at or above the 80th percentile group in F2 generation at 5 weeks of age were constantly higher than SBP falling at or below the 20th percentile group from 7 weeks of age onwards. 4. These results indicate that there exists 'tracking phenomenon of SBP in SHRSP' and that genetic factors regulate the rise in SBP. Tracking of SBP in F2 generation gives us new methodological insight into hypertensive mechanism in SHR.

Animals

Relative frequencies of dementia of the Alzheimer type and vascular dementia in Japanese nursing homes.

We have studied neuropathologically 200 aged nursing home residents (101 men and 99 women) autopsied between 1976 and 1985. Seventy-three of the 200 showed dementia during life, that is, 27% and 55% of the residents in nursing homes and special nursing homes, respectively. The relative frequencies of SDAT and VD in nursing homes as a whole were the same (34%). The relative frequencies of SDAT and VD in special nursing homes, where usually high concentrations of VD have been noted, were 21% and 52%, respectively. A comparison of the results of our special nursing homes (SDAT:VD = 1:2.5) and nursing homes as a whole (SDAT:VD = 1:1) with those of Barnes and Raskind (SDAT:VD = 2:1) and Rovner et al. (SDAT:VD = 3:1) showed that the frequencies of VD in Japanese nursing homes are considerably higher than those in their American counterparts.

Aged

[Cases of numerous diffuse plaques in the neocortex but without severe senile changes in the hippocampus].

Using modified Bielschowsky method, we studied neuropathologically 159 aged subjects autopsied during the period from 1976 to 1988, of which we found 19 cases (average age at death: 82.6 ys) with numerous diffuse plaques in the frontal and temporal neocortex and no severe senile changes in H1-H3 of Ammon's horn (dp group). Amyloid angiopathy had been excluded and one case was excluded because of considerable cerebrovascular lesions. The dp group was divided into 8 demented (average age at death: 86.0 ys) and 10 nondemented patients (average age at death: 79.7 ys). We compared the number, type, and ratio of types of senile plaques in the frontal cortex, temporal cortex, and putamen of the demented and nondemented groups, and obtained the following results: (1) Eight (14%) of the 59 nondemented and 8 (40%) of the 20 demented cases in which no severe senile changes in the neocortex and hippocampus had been detected by Bodian stain showed numerous diffuse plaques in the neocortex when the modified Bielschowsky method was used. (2) The ratio of classic and primitive plaques to diffuse plaques in the frontal cortex was the same in both groups, but the nondemented group had exclusively diffuse plaques in the temporal cortex. (3) In the putamen 2 nondemented cases (20%) and 6 demented cases (75%) had exclusively diffuse plaques. We considered that classic and primitive plaques are more closely related to dementia than are diffuse plaques in the temporal lobe in cases without severe senile changes in the hippocampus.

Aged

[A case of Binswanger disease with numerous diffuse plaques in the neocortex].

A case of Binswanger disease with numerous diffuse plaques in the neocortex was reported. This male patient had a previous history of hypertension and myocardial infarction. From the age of 60, he developed dysarthria, bradykinesia, marche à petit pas and falling down. Neurological examination at his first admission disclosed muscular rigidity and increased jaw and deep tendon reflexes, but dementia was not found. Brain CT showed moderate brain atrophy and EEG consisted of slow wave dysrhythmia. He was diagnosed of Parkinsonism and treatment started without effects. During his second admission for the treatment of myocardial infarction, at the age of 64, delirium developed. Progressive dementia began and finally he was confined to bed. From the age of 69, spontaneous speech became almost lost. Contracture of the extremities, increased deep tendon reflexes and force grasping were noted. Brain CT showed symmetrical low attenuation in the frontal and parietal white matter with moderate dilatation of the lateral ventricles. At the age of 70, he died of general prostration about ten years after the initial symptoms. Neuropathological findings: Macroscopic findings: The brain weighed 1300 g. Atherosclerotic changes of the large arteries at the base of the brain were moderate. Coronal sections of the brain showed moderate enlargement of the lateral ventricles with multiple small lacunes in the basal ganglia. Microscopic findings: Bilateral diffuse demyelination of the white matter with sparing of the U-fibers was noted. Holzer stain revealed fibrillary gliosis in the left parietal and occipital white matter. Marked adventitial fibrosis of the deep white matter arteries and terminal stages of hyalinosis of the perforating arteries were found. Basal ganglia showed status lacunaris. Bilateral pyramidal tracts were atrophic secondly.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

[A case of bilateral necrosis of the basal ganglia after hypotensive shocks].

We reported a case with bilateral necrosis of the basal ganglia after hypotensive shocks. The patient was a 69-year-old woman, who fell into a hypotensive shock (B.P. below 40 mmHg) of unknown origin during examination of her bladder cancer and was admitted into CCU. After admission, hypotensive shocks were repeated four times (B.P. below 50 mmHg each time). Neurological examination revealed a left spastic hemiplegia. Brain CT on 10th day showed bilaterally low density areas around the basal ganglia and a diagnosis of brain infarction was made. She gradually presented quadriplegia and symptomatic changes from pyramidal to extrapyramidal signs. Brain CT on 24th day showed bilateral hemorrhagic infarction of the basal ganglia with enhanced effect. On 79th day, she again fell into shock and died. Neuropathological examination of the brain was as follows. 1) laminar necrosis of the deep layers of the cerebral cortex, 2) bilateral necrosis of the hippocampal Sommer sector, 3) bilateral necrosis of the caudate nucleus, putamen and pallidum with neuronal loss and infiltration of fat granule cells, 4) sparing of the internal capsules, 5) bilateral necrosis of the reticular zone of the substantia nigra, 6) foci of fresh necrosis and loss of Purkinje cells in the cerebellum. These lesions are consistent with those of selective vulnerability in hypoxia as described by Scholz et al. An extensive distribution of cerebral as well as basal ganglia necrosis in this case was caused by repeated shocks.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

Joseph disease in a non-Portuguese family.

We studied four patients with Joseph disease in a Japanese family. There were two clinical types in the family. One was characterized by pyramidal and cerebellar signs with or without extrapyramidal signs; the other, by cerebellar signs, loss of tendon reflexes, and peripheral sensory loss. The family tree indicated autosomal-dominant inheritance. Neuropathologic examination revealed marked degeneration of the substantia nigra, dentate nuclei, Clarke column, and anterior horn cells of the spinal cord. This is the first report of pathologically proven Joseph disease in a non-Portuguese family.

Adult

Two autopsy cases of Pick's disease with neurofibrillary tangles.

Two cases of presenile dementia were presented. Both showed "stehende Redensarten" and aphasia. Histopathologically, besides Pick features--temporal lobe atrophy, fibrillary gliosis of the temporal white matter and neuronal loss in the 2--3 cortical layers--, Alzheimer features--neurofibrillary tangles and granulo-vacuolar degeneration--were found in both cases. But no senile plaques were found. Pseudocalcerous deposits were observed in the cerebral cortex, basal ganglia and cerebellum. Atypical cases with both Pick's and Alzheimer's diseases in the literature were classified into four groups according to the extent of the features of each disease. Sensory aphasia, which is relatively unusual in Pick's disease, was correlated to the atrophy of left T1, and similar cases in the literature were reviewed.

Alzheimer Disease

[Studies of blood flow through the spinal cord of rabbit using the H2 clearance method ].

Using the H2 clearance method, spinal cord blood flow of the rabbit could be steadily measured. This allowed examination of blood flow problems using data analysis to provide informed decisions as to whether or not the blood flow through the gray and white matter was distinguishable. Spinal cord blood flow was also compared through the cervical, thoracic, and lumbar cord regions. The results were as follows: 1. The H2 clearance curves consisted of about 70% monoexponential curve (Mono), and 30% biexponenial curve (Bi), with a tendency toward higher values in the latter. 2. In Bi, a significant positive correlation was noted between the total flow values and the initial slope method values. The initial slope method was therefore used for subsequent data analysis. 3. By using a histogram to evaluate the data on each medullary segment, it was possible to separate a subgroup with a peak around 20 ml/100 g/min and another one with a peak around 40 ml/100 g/min. Based on the microangiographic findings, a more abundant vascular distribution was demonstrated in the gray matter than in the white matter. The first subgroup was noted corresponding to the blood flow through the white matter, and the latter through the gray matter. When the blood flow through the white and gray matter was calculated according to the subgroup data base, the flow ratio through the white and gray matter was 1:2. 4. Comparing the blood flow through each spinal cord segment revealed no significant difference at a p level of 0.01.

Animals