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N Mimura

Publications and source records attributed to N Mimura.

At least 19 recordsLinked to original sources

Cervical discs are most susceptible to beta 2-microglobulin amyloid deposition in the vertebral column.

Intervertebral discs of 41 chronic renal failure autopsy cases were examined histologically and immunohistochemically to assess the distribution of beta 2-microglobulin-associated (beta 2m) amyloid in the vertebral column. The results demonstrated beta 2m amyloid to appear first in the cervical discs, then in the lumbar and upper thoracic discs, and finally in the middle and lower thoracic discs as the dialysis period is prolonged. The shortest dialysis period for which beta 2m amyloid was detected was one year and seven months. Deposition of beta 2m amyloid was most remarkable in the C4-5, 5-6, and 6-7 levels, which are known to sustain severe mechanical stress in daily life. Thus it is suggested that local mechanical stress accelerates beta 2m amyloidosis. A marked macrophage reaction was observed around the amyloid in cases of severe amyloidosis, the macrophages themselves being immunohistochemically positive for IL-1 beta and TNF-alpha. Amyloid deposition and reactive inflammation mediated by cytokines appear to be closely related to the pathogenesis of destructive spondyloarthropathy.

Adult

[Inflammatory cell infiltration around beta 2-microglobulin amyloid deposition: histologic comparison of beta 2-microglobulin amyloidosis with AA or AL amyloidosis].

Thirty-one autopsy cases of beta 2-microglobulin (beta 2M) amyloidosis were pathologically investigated in comparison with 17 autopsy cases of AA or AL amyloidosis. In 20 cases (65%, 20/31) of beta 2M amyloidosis, inflammatory cells, mainly macrophages were seen infiltrating around beta 2M amyloid in intervertebral disks. The more beta 2M amyloidosis advances, the more macrophage infiltration tends to be prominent. In cases of severe beta 2M amyloidosis, the cytoplasm of macrophages around amyloid deposition were swollen with engulfed amyloid substance and were often transforming to foreign body multinucleated giant cells. In addition, granulation tissue was formed with infiltrating macrophages, foreign body multinucleated giant cells, capillary proliferation and fibrosis around beta 2M amyloid deposition. On the other hand, inflammatory cell infiltration around amyloid deposition was scarcely seen in AA or AL amyloidosis. Ultrastructurally, macrophages were abundant in phagocytic vacuoles containing amyloid fibrils. These macrophages were immunohistochemically positive for CD68, IL-1 beta and TNF-alpha. Thus, macrophage infiltration around beta 2M amyloid is thought to be responsible for local pain and tissue destruction of dialysis patients.

Amyloid

Changes of enzyme activity levels in red blood cells in hemodialysis patients by recombinant human erythropoietin.

In a phase II clinical trial to test the ability of recombinant human erythropoietin (r-HuEPO) to reverse the anemia of patients undergoing hemodialysis, the changes of enzyme activity in red blood cells were evaluated in 5 hemodialysis anemic patients who were treated with r-HuEPO. Concerning the activity levels measured, the following conclusions are drawn. 1) HK, ALD, TPI, G6PD and 6PGD were statistically significantly increased at the time when the hematocrit has risen by 8% with the use of r-HuEPO. 2) The enzyme activity levels of PFK, GA3PD, MPGM, ENOL, PK, GR and ADA were higher than normal already before the r-HuEPO treatment. 3) The increases of HK and G6PD by r-HuEPO, as age dependent enzymes, may reflect the generation of young red blood cells. 4) In view of the fact that they are related to ATP production in the glycolysis cycle, we infer that increases of red blood cell enzymes by r-HuEPO may play at least some part in bringing a sensation of "well-being" to severely anemic patients undergoing hemodialysis.

Adenosine Triphosphate

Beta 2-microglobulin amyloidosis in hemodialysis patients. An autopsy study of intervertebral disks and posterior longitudinal ligaments.

Ninety-five autopsy cases of chronic renal failure, which had or had not been treated by hemodialysis, were examined histologically and immunohistochemically for evidence of amyloid deposition in the intervertebral disks and posterior longitudinal ligaments of the spine. beta 2-Microglobulin (beta 2M) amyloid was not present in non-dialyzed patients with chronic renal failure. In cases showing beta 2M amyloid deposition, the shortest term of hemodialysis was 2 years and 5 months. The incidence of beta 2M amyloidosis tended to increase as the dialysis period was prolonged. An inverse correlation was present between dialysis period and age in 22 cases showing beta 2M amyloid deposition (correlation coefficient: -0.43, p less than 0.05), and beta 2M amyloidosis tended to occur earlier in elderly patients than in younger patients. This suggests that elderly patients are more susceptible to beta 2M amyloidosis. beta 2M amyloid was absent in all of 8 cases of systemic lupus erythematosus which were treated by dialysis for periods ranging from 2 days to 12 years. In these patients, beta 2M amyloidosis may have been prevented by steroids, which had been administered for long periods in all cases. Another amyloid of unknown composition was also frequently present in the intervertebral disks and posterior longitudinal ligaments not only in patients with chronic renal failure but also control patients without chronic renal failure. This amyloid was immunohistologically negative for beta 2M, amyloid A protein, light chain kappa or lambda, prealbumin, and apolipoprotein A-II.

Aging

[Clinico-pathological evaluation of mesangial IgA deposition of minimal change with nephrotic syndrome].

The case of IgA glomerulonephritis that shows minimal change with nephrotic syndrome is unusual. Thirteen patients of mesangial IgA deposition of minimal change with nephrotic syndrome (IgAMCNS) are discussed in comparison with twenty patients of non IgA deposition of minimal change with nephrotic syndrome (MCNS). On a common basis of hematuria, two groups are undistinguished. On a reaction pattern to steroid treatment, the former is based on IgA nephritis and the latter is based on minimal change with nephrotic syndrome. There is no difference in light microscopical findings between the two groups. Electron microscopically, the former suggests IgA nephritis and the latter suggests minimal change with nephrotic syndrome. In immunofluorescence, the former group is rare to show typical IgA glomerulonephritis. In conclusion, IgAMCNS is considered to be nephrotic syndrome with asymptomatic IgA deposit in mesangium.

Adolescent

Effect of dialysis treatment on glucose metabolism in uremic patients.

To study the carbohydrate metabolism in uremic patients, the intravenous glucose tolerance test (iv GTT) and insulin sensitivity test were investigated on 69 patients with chronic renal failure, 27 of whom were under the dialysis treatment. 1) Abnormal K-values averaging 1.05 were obtained in uremic patients (creatinine clearance less than 20 ml/min). 2) Carbohydrate intolerance in uremic patients was corrected with regular dialysis and the improvement was correlated with the duration of dialyses. 3) The mechanisms of improvement in carbohydrate metabolism were different between the short-term dialysis group (less than 12 months of dialysis) and the long-term group (more than 12 months). Enhanced secretion of insulin seemed to be the main cause of this improvement in the former, while the correction of impaired sensitivity to insulin in peripheral tissues in the latter.

Adolescent