H Shiiki

Kyushu University, Hukuoka, Fukuoka, Japan

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Publications (6)45.3 Total impact

  • H Shiiki, T Shimokama, T Watanabe
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    ABSTRACT: A biopsy specimen exhibiting the typical morphologic characteristics of temporal arteritis was studied by using light immunofluorescent, and electron microscopy and immunohistochemical techniques. The granulomatous lesion consisted of clusters of macrophages, epithelioid cells, giant cells, and the peripheral lymphocyte mantle, and was localized mainly in the media. Neutrophils were rare, and fibrinoid necrosis was absent. In immunofluorescent and immunohistochemical studies, no significant deposition of immunoglobulins or complement was observed. Immunohistochemical study with monoclonal antibodies to leukocyte surface antigens demonstrated that the central aggregated granulomatous infiltrate consisted of OKTM1+, Leu-M3+, HLA-DR+ epithelioid macrophages and multinucleated giant cells, whereas OKT8+, HLA-DR+ (suppressor/cytotoxic) T cells predominated in the peripheral lymphocyte mantle. These findings suggest that cell-mediated immunity, especially T cell-regulated granulomatous reaction, may play an important role in the pathogenesis of temporal arteritis. By electron microscopy, smooth muscle cells often exhibited closely attached macrophages, epithelioid cells, and giant cells, and displayed a variety of cell injuries. It therefore seems likely that smooth muscle cells are a primary target of the granulomatous reaction.
    Human Pathlogy 12/1989; 20(11):1057-64. · 2.84 Impact Factor
  • Nephron 02/1989; 51(3):418-9. · 13.26 Impact Factor
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    ABSTRACT: Six cases of perimembranous-type renal amyloidosis were reported. This type of renal amyloidosis was characterized by amyloid deposition predominantly involving the epithelial aspect of the glomerular capillary wall. Florid spicular arrangement was another representative feature. This type of amyloid deposition was found in 8% of autopsy cases of systemic amyloidosis. All cases were categorized as AL amyloidosis and developed the nephrotic syndrome irrespective of the amount of amyloid within the glomeruli. The results obtained suggest that perimembranous-type renal amyloidosis is a peculiar form of AL amyloidosis both in morphology and clinical manifestations. autopsy cases of systemic amyloidosis. All cases were categorized as AL amyloidosis and developed the nephrotic syndrome irrespective of the amount of amyloid within the glomeruli. The results obtained suggest that perimembranous-type renal amyloidosis is a peculiar form of AL amyloidosis both in morphology and clinical manifestations. autopsy cases of systemic amyloidosis. All cases were categorized as AL amyloidosis and developed the nephrotic syndrome irrespective of the amount of amyloid within the glomeruli. The results obtained suggest that perimembranous-type renal amyloidosis is a peculiar form of AL amyloidosis both in morphology and clinical manifestations.
    Nephron 02/1989; 53(1):27-32. · 13.26 Impact Factor
  • Nephron 01/1989; 51(3):418-419. · 13.26 Impact Factor
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    ABSTRACT: Sixty-one autopsy cases of renal amyloidosis were reviewed to assess the relationship of renal pathology to chemical types of amyloid and clinical features. Glomerular amyloid deposition was divided on the basis of morphological characteristics, into four types: a mesangial nodular type showing nodular mesangial deposits with sparse capillary wall involvement (25 cases), a mesangio-capillary type disclosing diffuse amyloid deposition in the mesangium and along both sides of the glomerular basement membrane (19 cases), a perimembranous type principally involving the subepithelial side of the basement membrane invariably characterized by exuberant spicular arrangement (6 cases), and a hilar type showing amyloid deposits almost exclusively in hilar arterioles (11 cases). Twenty-four of 25 cases of mesangial nodular type (96%) showed amyloid protein of AA type. However, mesangio-capillary and perimembranous types were associated with deposition of AL amyloid protein in 15 of 19 (79%) and all 6 cases, respectively. Nephrotic syndrome was more frequent in patients with AL amyloidosis; notably, all patients with perimembranous type had nephrotic syndrome irrespective of the extent of glomerular amyloid deposits. Chronic renal failure and renal death appeared more common in mesangial nodular type in which the extent of glomerular amyloidosis correlated with that of vascular amyloid deposits. The results obtained suggest that the chemical type of glomerular amyloid protein (AA vs AL) is associated with significant differences in the morphological, clinical and prognostic features of the renal involvement.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 04/1988; 412(3):197-204. · 2.68 Impact Factor
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    ABSTRACT: Sixty-one autopsy cases of renal amyloidosis were reviewed to assess the relationship of renal pathology to chemical types of amyloid and clinical features. Glomerular amyloid deposition was divided on the basis of morphological characteristics, into four types: a mesangial nodular type showing nodular mesangial deposits with sparse capillary wall involvement (25 cases), a mesangio-capillary type disclosing diffuse amyloid deposition in the mesangium and along both sides of the glomerular basement membrane (19 cases), a perimembranous type principally involving the subepithelial side of the basement membrane invariably characterized by exuberant spicular arrangement (6 cases), and a hilar type showing amyloid deposits almost exclusively in hilar arterioles (11 cases). Twenty-four of 25 cases of mesangial nodular type (96%) showed amyloid protein of AA type. However, mesangio-capillary and perimembranous types were associated with deposition of AL amyloid protein in 15 of 19 (79%) and all 6 cases, respectively. Nephrotic syndrome was more frequent in patients with AL amyloidosis; notably, all patients with perimembranous type had nephrotic syndrome irrespective of the extent of glomerular amyloid deposits. Chronic renal failure and renal death appeared more common in mesangial nodular type in which the extent of glomerular amyloidosis correlated with that of vascular amyloid deposits. The results obtained suggest that the chemical type of glomerular amyloid protein (AA vs AL) is associated with significant differences in the morphological, clinical and prognostic features of the renal involvement.
    Virchows Archiv. A, Pathological anatomy and histopathology 02/1988; 412(3):197-204.