Publications by authors named "Naiki H"

Article Synopsis
  • A study examined the prevalence of amyloid deposits in aortic valves from 97 patients undergoing valve replacement for aortic stenosis (AS), uncovering a significant association with junctional amyloid types.
  • Results indicated that 45% of the valves contained amyloid deposits, predominantly from transthyretin-type (ATTR) and amyloid derived from ApoAI (AApoAI), which may affect clinical outcomes.
  • The findings suggest that patients with amyloid deposition in the aortic valve exhibit earlier symptoms of AS despite maintaining preserved left ventricular function.
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Post-mortem computed tomography (PMCT) is a useful tool to investigate the cause of death. To appropriately use PMCT for cause-of-death analysis, it is necessary to know natural courses after death such as hypostasis in the lungs. We aimed to investigate the natural time-course change of postmortem chest CT findings and its pathological correlation in piglets.

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Spleen tyrosine kinase (Syk), a non-receptor-type tyrosine kinase, has a wide range of physiological functions. A possible role of Syk in Alzheimer's disease (AD) has been proposed. We evaluated the localization of Syk in the brains of patients with AD and control participants.

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Article Synopsis
  • Oral elastofibromatous lesions (OEFLs) are rare, benign growths in the mouth marked by an increase in elastic fibers, exemplified by a case involving an 83-year-old male with a lesion on his tongue.
  • The lesion resembled a painless, yellowish-white plaque about 4 x 3 mm in size and was initially diagnosed as an irritation fibroma or lipoma before being confirmed as an OEFL after surgical removal.
  • Follow-up after nearly five years showed no recurrence or issues at the surgical site, and the study also reviewed similar cases from the literature to provide additional context.
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Background: Although immunohistochemical techniques and proteomic analysis are widely used for typing diagnosis of amyloidosis, the diagnostic utility of immunohistochemical evaluation is not well understood.

Methods: We used immunohistochemical techniques to characterize staining patterns of in-house rabbit polyclonal anti-κ, anti-λ, anti-transthyretin antibodies, and commercial anti-amyloid A and anti-β-microglobulin antibodies in 40 autopsy cases.

Results: In thirty cases (75%), the subtype was determined by using the criterion that amyloid is strongly and diffusely positive for one antibody while negative for other antibodies.

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Podocyte expression of fibroblast specific protein 1 (FSP1) is observed in various types of human glomerulonephritis. Considering that FSP1 is secreted extracellularly and has been shown to have multiple biological effects on distant cells, we postulated that secreted FSP1 from podocytes might impact renal tubules. Our RNA microarray analysis in a tubular epithelial cell line (mProx) revealed that FSP1 induced the expression of heme oxygenase 1, sequestosome 1, solute carrier family 7, member 11, and cystathionine gamma-lyase, all of which are associated with nuclear factor erythroid 2-related factor (Nrf2) activation.

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Clinical presentation of systemic amyloidosis differs among subtypes, and accurate subtype classification is important for choosing the treatment. Amyloid transthyretin (ATTR) amyloidosis was the predominant among the recently consulted amyloidosis cases in Japan. To reveal the latest subtype frequency of systemic amyloidosis among autopsy cases in Japan.

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Despite the dedicated research of artificial intelligence (AI) for pathological images, the construction of AI applicable to histopathological tissue subtypes, is limited by insufficient dataset collection owing to disease infrequency. Here, we present a solution involving the addition of supplemental tissue array (TA) images that are adjusted to the tonality of the main data using a cycle-consistent generative adversarial network (CycleGAN) to the training data for rare tissue types. F1 scores of rare tissue types that constitute < 1.

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We retrospectively gathered data of 21 patients (13 male and 8 female; median age 65 years) diagnosed with immunoglobulin M (IgM)-related light-chain (AL) amyloidosis in Japan to investigate characteristics of IgM-AL amyloidosis and its optimal treatment strategy. Median IgM and difference free light chain (FLC) at diagnosis were 1257 mg/dl and 34.3 mg/l, respectively.

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A 65-year-old man presented with apparent bronchopneumonia. After treatment with antibiotics, he showed eosinophilia. Computed tomography (CT) imaging revealed bilateral consolidation, ground-glass opacities with nodular consolidations, and pleural effusion.

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Although Sepsis-3 doesn't require evidence of bacteremia to diagnose sepsis, clinicians often want to identify the causative pathogen at autopsy. In principle, if the blood cultures are the same at ante- and postmortem, the cause of death is obvious. However, interpretations of postmortem blood cultures are often difficult due to discordance, negativity, mixed infection, and contamination, of pathogens occupying ≥ 50% of the tests.

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Background: Light and heavy chain deposition disease (LHCDD) is a rare condition characterised by the deposition of immunoglobulin components in the kidneys. Similarly, Amyloidosis is also caused by the deposition of light chain and/or heavy chain components of immunoglobulins which are folded into amyloid fibrils characterised by Congophilic deposits that exhibit apple-green birefringence under polarised light. Only a handful of reports describing LHCDD with amyloid fibril deposition have been previously published, however, none have characterized the composition of the deposited immunoglobulin components via mass spectrometry.

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Background: In 2019, 2020 and 2022, the Japanese Government approved the use of tafamidis and two technetium-scintigraphies for transthyretin amyloid (ATTR) cardiomyopathy, and announced the patient criteria for tafamidis therapy. In 2018, we had started a nation-wide pathology consultation of amyloidosis.

Objective: To reveal the impact of approval of tafamidis and technetium-scintigraphy on the diagnosis of ATTR cardiomyopathy.

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Dialysis-related amyloidosis (DRA), a serious complication among long-term hemodialysis patients, is caused by amyloid fibrils of β2-microglobulin (β2m). Although high serum β2m levels and a long dialysis vintage are the primary and secondary risk factors for the onset of DRA, respectively, patients with these do not always develop DRA, indicating that there are additional risk factors. To clarify these unknown factors, we investigate the effects of human sera on β2m amyloid fibril formation, revealing that sera markedly inhibit amyloid fibril formation.

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We report on an 80-year-old man diagnosed with Fanconi syndrome induced by mizoribine after 4 weeks of administration to treat membranous nephropathy. Mizoribine is an oral immunosuppressant that inhibits inosine monophosphate dehydrogenase and is widely used in Japan for the treatment of autoimmune diseases and nephrotic syndrome, as well as after renal transplantation. Acquired Fanconi syndrome is often caused by drugs (antibacterial, antiviral, anticancer, and anticonvulsant drugs) and is sometimes caused by autoimmune diseases, monoclonal light chain-associated diseases, or heavy metal poisoning.

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Congenital hepatic fibrosis is a rare autosomal recessive disorder caused by ductal plate malformation that can manifest as hepatic fibrosis alone or as a component in various fibropolycystic diseases including renal involvement. It is often diagnosed early in life, presenting with ascites and esophageal variceal bleeding due to non-cirrhotic portal hypertension. Here, we report a rare case of congenital hepatic fibrosis with portal hypertension diagnosed at an advanced age.

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The diagnosis of cardiac amyloidosis is frequently delayed because histological confirmation is often challenging. Few studies have attempted to clarify the utility and safety of abdominal fat pad fine-needle aspiration (FPFNA) for an initial screening test in patients with suspected cardiac amyloidosis.This study included 77 consecutive patients with suspected non-ischemic cardiomyopathy who had left ventricular dysfunction and/or hypertrophy.

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Article Synopsis
  • The study reviews amyloidosis cases from autopsies to identify characteristics specific to Japanese patients and emphasizes the importance of accurately classifying the type of amyloidosis for effective treatment, as different types have varied therapeutic agents.* -
  • A total of 131 cases were classified using immunohistochemistry, revealing that transthyretin amyloidosis was the most common type, followed by AA amyloidosis, light-chain amyloidosis, and β2-microglobulin amyloidosis, with all cases showing myocardial involvement.* -
  • The findings highlight distinct histopathological patterns associated with different amyloidosis types, with approximately 90% of cases accurately classified using standard antibodies available in the market.*
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An 85-year-old man with a history of aortic dissection suddenly fainted, underwent cardiac heart arrest, and died. An autopsy was performed, but the cause of death was not grossly identified. Congo red staining detected amyloid deposits in systemic organs, including the heart, lungs, liver, and kidneys.

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Article Synopsis
  • - Secondary amyloidosis, often linked to chronic inflammatory diseases, can cause serious gastrointestinal issues including symptoms like diarrhea and low protein levels, and is typically challenging to treat.
  • - A case study details a 70-year-old woman with severe gastrointestinal AA amyloidosis, diagnosed after extensive tests showed significant damage and amyloid buildup in her intestine, likely caused by long-standing kidney issues.
  • - Following treatment that involved resolving her ureteral obstruction and administering antibiotics, the patient showed significant improvement, highlighting the need for thorough evaluation of gastrointestinal health in similar cases.
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Article Synopsis
  • * A kidney biopsy showed inflammation and damage, but the man's condition did not meet the criteria for IgG4-related diseases or sarcoidosis; steroid treatment improved his symptoms.
  • * After 5 years, the patient's condition worsened with an increase in neutrophils and a respiratory infection, leading to necrotizing crescentic glomerulonephritis, suggesting a link between persistent neutrophil increases, respiratory infections, and kidney complications in older adults with MPO-ANCA.
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Background: Chronic hypoxia may play a pivotal role in the development of diabetic nephropathy (DN). However, the precise mechanisms underlying progressive hypoxia-induced glomerular injury remain unclear.

Methods: We housed db/db mice in a hypoxia chamber (12% O2) for up to 16 weeks beginning at 8 weeks of age.

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The molecular pathogenesis of human amyloidosis has been elucidated greatly during the last 20 years. Based on the understanding of the molecular mechanisms of amyloid fibril formation and deposition, various kinds of new drugs and therapeutics have been emerging to improve the prognosis of amyloidosis and even cure this disease. In this review article, we first summarize the pathogenesis and state-of-the-art therapeutics of representative types of systemic human amyloidosis, that is, immunoglobulin light chain-related, transthyretin-related, amyloid A-associated and β -microglobulin-related amyloidosis.

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