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K Kosaka

Publications and source records attributed to K Kosaka.

676 records · Page 38Linked to original sources
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An autopsied case of juvenile parkinsonism and dementia, with a widespread occurrence of Lewy bodies and spheroids.

An autopsied case of juvenile parkinsonism and dementia is described. The patient is a 48-year-old man who had a ten-year history of parkinsonian syndrome and progressive dementia. Neuropathological examination revealed a widespread occurrence of Lewy bodies and spheroids in the central nervous system. Lewy bodies were found not only in the brain stem and diencephalon, but also in the cerebral cortex. Massive numbers of small spheroids were observed in the globus pallidus, substantia nigra, mamillary bodies and hippocampus. Electron microscopical examination showed that most spheroids were composed of degenerative organelles with only a few neurofilaments, and were different from those of Hallervorden-Spatz disease. There was also marked neuronal loss with gliosis in the CA3-4 of the hippocampus. Some neurofibrillary tangles occurred in the hippocampus, subcortical and brain stem nuclei, but senile plaques were absent. This case may represent an atypical form of pure diffuse Lewy body disease.

Brain↗
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Familial presenile dementia with CJD-like lesions: preliminary results.

A case of an unknown type of familial presenile dementia is reported. The patient was a 56-year-old female, whose main clinical symptom was a gradually progressive dementia over 16 years. She had no myoclonus or periodic synchronous discharge in the EEG. The CT scans revealed marked cerebral atrophy with prominent atrophy of the cerebral white matter. One of her sisters is thought to suffer from the same disease, and is now in an apallic state. The patient was clinically diagnosed as having familial Alzheimer's disease. The neuropathological features consisted of severe cerebral cortical degeneration with conspicuous proliferation of gemistocytic astrocytes as well as severe cerebral white matter degeneration. These cerebral lesions are most similar to those of the panencephalopathic type of Creutzfeldt-Jakob's disease (CJD). However, our case differs from it in that the cerebellar degeneration was very mild. Transmission experiments of frozen tissue from the patient into animals are being tried. The neurochemical data suggested cholinergic deficits. As far as we know, such a case has never been reported in the literature.

Astrocytes↗
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Lewy body disease with and without dementia: a clinicopathological study of 35 cases.

The pathological basis for dementia in Lewy body disease (LBD) remains controversial. While some investigators propose that cortical lesions are responsible, others favor a subcortical basis for this dementia. Brains from 35 patients with LBD (11 demented with diffuse LBD; 12 demented and 12 non-demented with a brainstem type of LBD) were clinicopathologically examined to elucidate the pathological differences between demented and non-demented patients with LBD. In cases of diffuse LBD, the cortical lesions were found to be responsible for the dementia. In some of the cases (25%) with the brainstem type of LBD, the dementia was attributed to an Alzheimer pathology, while in many cases (75%), degeneration in the subcortical nuclei, mainly the nucleus basalis of Meynert, played a major role in the dementia.

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Diffuse type of Lewy body disease: progressive dementia with abundant cortical Lewy bodies and senile changes of varying degree--a new disease?

The term Lewy body disease (LBD) was proposed earlier to describe a disease classified into three types (A, B, and C) according to the distributional pattern of Lewy bodies in the CNS. Group A (diffuse type of LBD) shows clinical symptoms of "dementia-parkinsonism syndrome". The most remarkable pathologic feature is the widespread appearance of numerous Lewy bodies not only in the brain stem and diencephalon (as in group C), but also in the cerebral cortex and basal ganglia, which is complicated by senile changes of various degrees. Group B is the transitional type between groups A and C. Group C (brain stem type of LBD) is identical with idiopathic Parkinson's disease. In this paper, 12 of our cases with diffuse type LBD were studied clinicopathologically and compared with eight similar cases in the literature. The neuropathologic substrate of progressive dementia in this disease is also discussed. LBD is a clinicopathologic entity; the diffuse type of LBD, a special form of this disease, presents mainly a presenile dementia.

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Comparative clinical pharmacology of human insulin (Novo) and porcine insulin in normal subjects.

The pharmacokinetics and pharmacologic effects of human insulin (Novo) derived from porcine insulin were studied by a double-blind crossover comparison with porcine monocomponent insulin in healthy volunteers. Both insulins were given by subcutaneous (s.c.) and intravenous (i.v.) injection to healthy male volunteers. The doses of injected insulin were 0.05 U/kg and 0.1 U/kg for the s.c. study, and 0.025 U/kg and 0.05 U/kg for the i.v. study. The plasma immunoreactive insulin (IRI) increased rapidly, plasma C-peptide and glucose decreased gradually, and plasma glucagon increased transiently after injection of the insulins. The pharmacokinetics and pharmacologic actions of human insulin were essentially similar to those of porcine insulin. The area under the time-concentration curve (AUC) of IRI was slightly greater after s.c. injection of human insulin than after that of porcine insulin at the 0.05-U/kg dose level. Because no significant difference was observed in the plasma C-peptide level and no such difference was noticed in the AUC of IRI between the two insulins after i.v. injection, the bioavailability of human insulin seemed to be greater than that of porcine insulin after s.c. injection. The plasma glucose-reducing effect was slightly greater after s.c. injection of 0.05 U/kg of human insulin than after s.c. injection of the same dose of porcine insulin. Apart from symptoms of hypoglycemia (sweating, palpitations, and hot flushes), no other unwanted reactions were observed after administration of either insulin. These results suggest that human insulin has a usefulness similar to that of porcine insulin in clinical practice. The clinical relevance of the slight difference in bioavailability observed in the s.c. study remains to be investigated.

Adult↗
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A non-alcoholic Japanese patient with Wernicke's encephalopathy and Marchiafava-Bignami disease.

In Japan Wernicke's encephalopathy is not rare, but only one case of Marchiafava-Bignami disease has been reported. In our case, Wernicke lesions were found in the mamillary bodies, septal nuclei, and periventricular regions. Involvement of the septal nuclei is rare in this encephalopathy. A characteristic Marchiafava-Bignami lesion was observed only in the anterior part of the corpus callosum. From the clinicopathologic viewpoint, Wernicke's encephalopathy might have preceded Marchiafava-Bignami disease in our case. To our knowledge, only two cases without a history of alcoholism and both suffering from Wernicke's encephalopathy and Marchiafava-Bignami disease have been documented. However, in both cases Wernicke lesions were atypical, since characteristic lesions were absent in the mamillary bodies and in the regions surrounding the third ventricle and the aqueduct. Ours appears to be the first report on a non-alcoholic patient with typical lesions of both diseases.

Alcohol Drinking↗
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Adult type of neuronal ceroid-lipofuscinosis with retinal involvement.

A rare case of Kufs' disease with retinal lesions is reported in which the first symptom of visual disturbances later resulted in total blindness. Various neurologic symptoms and mental deterioration also developed. The total duration of the illness was 32 years. Neuropathologic examination showed extensive ballooned nerve cells filled with lipopigments in the CNS. In the retina there was a thinning with severe loss of rods, cones, and outer nuclear and outer plexiform layers. The remaining ganglion cells of the retina were also ballooned and accumulated with lipopigments. Histochemical and electron microscopic examinations disclosed that the lipopigments in the ballooned neurons of the CNS and the retina were identical with lipofuscin pigments.

Adult↗
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Progressive supranuclear palsy with fronto-temporal atrophy and various tau-positive abnormal structures.

An autopsy case of a 67-year-old man with typical clinical features of progressive supranuclear palsy (PSP) characterized by impairment of vertical ocular pursuit movement, pseudobulbar palsy, nuchal stiffness, parkinsonism, and dementia is described. In addition to typical pathological changes of PSP, the present case showed fronto-temporal cortical atrophy, accompanied with various Gallyas/tau-positive neuronal and glial structures such as neurofibrillary tangles, pretangle neurons, glial coiled bodies, astrocytic plaques and argyrophilic threads in the cerebral cortex and subcortical nuclei, and many senile plaques throughout the whole cerebral cortex. The present report suggests that PSP and corticobasal degeneration share a common background in neuronal and glial pathologies, that pathological changes of PSP and Alzheimer's disease are mixed in the entorhinal cortex, amygdala. Meynert nucleus, and hypothalamus, and that dementia with frontal lobe-like syndrome in PSP is related to the frontal and temporal cortical pathologies, and is cortical dementia as well as subcortical dementia.

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