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Effects of fluctuating glucose concentrations on oxidative metabolism of glucose in cultured neurons and astroglia

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Journal of Diabetes Mellitus 2012年第1期2卷 19-26页

作者： shinichi takahashi Takato Abe Yoshikane Izawa Norihiro Suzuki Department of Neurology School of Medicine Keio University Tokyo Japan

The objective of the present study was to evaluate the effects of hyperglycemia on glucose metabolism of brain cells. Not only a sustained hyperglycemic state, but also a fluctuating plasma glucose concentration has been implicated in the pathogenesis of diabetic angiopathy. Acutely increasing plasma glucose levels have not been reported to alter glucose utilization of the brain as a whole. In the present study, we examined the effects of chronic (3 weeks) or short-term (24-hour) exposure to a high glucose concentration on the oxidative metabolism of neurons and astroglia. Cells were prepared from Sprague-Dawley rats and cultured in the presence of a high (22 mM) or low (5 mM) concentration of glucose. The high or low glucose media did not alter either the rates of [14C]deoxyglucose phosphorylation (an indicator of total glucose utilization) or [14C]lactate and [14C]pyruvate oxidation (indicators of oxidative glucose metabolism) in neurons. In contrast, chronic or short-term exposure to a high glucose concentration resulted in significant decreases in oxidation of [14C]acetate, an astrocyte-specific reporter molecule, or [14C]lactate and [14C]pyruvate oxidation in the astroglia. Thus, either chronic or short-term increases in the glucose concentration suppressed oxidative metabolism only in astroglia, indicating neuro-protective roles against hyperglycemic brain cell injury in diabetes mellitus. These different responses of neurons and astroglia may also shed new light on brain energy metabolism in diabetic patients with either chronic high or fluctuating plasma glucose concentrations.

关键词： Astrocyte Diabetic Encephalopathy Hyperglycemia [14C]acetate [14C]deoxyglucose [14C]lactate [14C]pyruvate

Knee locking caused by osteochondroma of the proximal tibia adjacent to the pes anserinus:A case report

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World Journal of Clinical Cases 2023年第23期11卷 5595-5601页

作者： Tatsuru Sonobe Michiyuki Hakozaki Yohei Matsuo Yojiro takahashi Katsuhiro Yoshida shinichi Konno Department of Orthopaedic Surgery Fukushima Medical University School of MedicineFukushima 960-1295Japan Department of Orthopaedic Surgery Fukushima General Health and Welfare CentreFukushima 963-8041Japan Higashi-Shirakawa Orthopaedic Academy Fukushima Medical University School of MedicineFukushima 960-1295Japan Department of Orthopaedic Surgery Fujita General HospitalFukushima 969-1793Japan

BACKGROUND Osteochondroma is one of the most common benign bone tumors,and it may cause bone and joint deformities and limited range of motion of an adjacent *** pes anserinus region is one of the most frequent sites of osteochondroma,but knee locking caused by osteochondromas in the pes anserinus region is extremely *** SUMMARY We describe a 13-year-old Japanese girl’s extra-articular knee locking that occurred when the semitendinosus tendon got caught in osteochondroma that had developed in the pes anserinus *** osteochondroma was surgically *** postoperative outcome has been excellent,with no recurrence of knee locking or tumor one-year *** When a young person develops knee locking,the possibility of extra-articular as well as intra-articular locking should be ***,one of the causes of extra-articular locking,can be treated with surgery with good postoperative results.

关键词： Extra-articular knee locking Impingement Osteochondroma Pes anserinus Tibia Surgery Case report

Biliary drainage strategy of unresectable malignant hilar strictures by computed tomography volumetry

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World Journal of Gastroenterology 2015年第16期21卷 4946-4953页

作者： Ei takahashi Mitsuharu Fukasawa Tadashi Sato shinichi Takano Makoto Kadokura Hiroko Shindo Yudai Yokota Nobuyuki Enomoto First Department of Internal Medicine Faculty of MedicineUniversity of Yamanashi

AIM:To identify criteria for predicting successful drainage of unresectable malignant hilar biliary strictures(UMHBS) because no ideal strategy currently ***:We examined 78 patients with UMHBS who underwent biliary *** was considered effective when the serum bilirubin level decreased by ≥ 50% from the value before stent placement within 2 wk after drainage, without additional *** that occurred within 7 d after stent placement were considered as early *** drainage, the liver volume of each section(lateral and medial sections of the left liver and anterior and posterior sections of the right liver) was measured using computed tomography(CT) *** liver volume was calculated based on the volume of each liver section and the type of bile duct stricture(according to the Bismuth classification).Tumor volume, which was calculated by using CT volumetry, was excluded from the volume of each *** operating characteristic(ROC) analysis was performed to identify the optimal cutoff values for drained liver *** addition, factors associated with the effectiveness of drainage and early complications were ***:Multivariate analysis showed that drained liver volume [odds ratio(OR) = 2.92, 95%CI:1.648-5.197; P < 0.001] and impaired liver function(with decompensated liver cirrhosis)(OR = 0.06, 95%CI:0.009-0.426; P = 0.005) were independent factors contributing to the effectiveness of *** analysis for effective drainage showed cutoff values of 33% of liver volume for patients with preserved liver function(with normal liver or compensated livercirrhosis)and 50%for patients with impaired liver function(with decompensated liver cirrhosis).The sensitivity and specificity of these cutoff values were82%and 80%for preserved liver function,and 100%and 67%for impaired liver function,*** patients who met these criteria,the rate of effective drainage among those with

关键词： Biliary drainage Computed tomographyvolumetry Hilar biliary stricture Cholangiocarcinoma Liver function Cholangitis

Clinical significance of hypoechoic submandibular gland lesions in type 1 autoimmune pancreatitis

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World Journal of Gastroenterology 2017年第18期23卷 3295-3300页

作者： shinichi Takano Mitsuharu Fukasawa Makoto Kadokura Hiroko Shindo Ei takahashi Sumio Hirose Yoshimitsu Fukasawa Satoshi Kawakami Tadashi Sato Nobuyuki Enomoto First Department of Internal Medicine Faculty of Medicine University of Yamanashi

To assess the role of ultrasonography of submandibular glands (SGs) in the diagnosis of type 1 autoimmune pancreatitis (AIP).METHODSThirty-seven patients who were definitively diagnosed with type 1 AIP according to the international consensus diagnostic criteria (ICDC) for AIP at our institution between December 1990 and April 2016 were retrospectively reviewed. Findings by physical examination, ultrasonography, and scintigraphy of SGs were analyzed to reach a diagnosis based on the ICDC for AIP. The efficacy of corticosteroid treatment in the resolution of hypoechoic lesions in SGs was also evaluated by assessment with ultrasonography before and after treatment in 18 *** sensitivity of multiple hypoechoic lesions in SGs by ultrasonography for the diagnosis of sialadenitis in type 1 AIP (84%) was higher than that of physical examination (46%), scintigraphy (28%), and SGs thickness (49%). Ultrasonographic evidence of hypoechoic lesions in SGs improved the definitive diagnosis of sialadenitis and type 1 AIP by the ICDC criteria in 11 (30%) and 2 (5.4%) cases, respectively. Multiple hypoechoic lesions in SGs were resolved or disappear by corticosteroid administration in 14 of 16 cases with hypoechoic lesions in SGs, whereas the ultrasonographic findings in the remaining 2 cases with hypoechoic lesions in SGs and the 2 cases with homogenous SG parenchyma remained unchanged after corticosteroid *** ultrasonography to detect multiple hypoechoic lesions might be useful for type 1 AIP diagnosis by improving diagnostic accuracy together with the ICDC sialadenitis criteria.

关键词： Autoimmune pancreatitis Ultrasonography Submandibular glands International consensus diagnostic criteria Sialadenitis

Center of gravity transfer velocity during sit-to-stand is closely related to physical functions regarding fall experience of the elderly living in community dwelling

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Health 2013年第12期5卷 2097-2103页

作者： Takayoshi Yamada shinichi Demura Kenji takahashi Faculty of Community Health Care Teikyo Heisei University Chiba Japan Faculty of Education and Regional studies University of Fukui Fukui Japan Graduate School of Natural Science & Technology Kanazawa University Ishikawa Japan

This study examines the difference of the center of gravity (CG) velocity during sit-to-stand (STS) movement between the elderly with and without fall experience. Fifteen elderly without fall experience (age: 75.7 ± 4.8 yr), with one fall experience (age: 75.7 ± 5.0 yr), and two or more fall experiences (age: 75.7 ± 4.8 yr) participated in the measurement of 10m maximal walking speed, functional reach, one-legged standing duration with vision, maximal isometric knee extension, hip flexion, ankle extension and toe flexion muscle strengths, fall risk assessment and ADL questionnaire, and CG velocity during STS movement. No significant differences were found in muscle strength, walking and balance tests (F 0.078). The group with two or more fall experiences was significantly higher than the other groups in the fall risk assessment, and lower than the group without fall experience in ADL (F = 8.5 and 6.1, p = 0.001 and 0.005). Meanwhile, significant differences were found in the maximal and mean CG velocity during STS movement among all groups. The group without fall experience was the greatest, and the group with fall experience was less than half (F = 9.0 and 11.1, p = 0.001

关键词： Sit-to-Stand Movement Physical Function Fall

Evaluating the effects of pain and disorders of the knee joint on knee extension strength and daily life activities in the female elderly

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Pain Studies and Treatment 2013年第3期1卷 17-23页

作者： Hiroki Sugiura shinichi Demura Kenji takahashi Faculty of Community Health Care Teikyo Heisei University Chiba Japan Graduate School of Natural Science and Technology Kanazawa University Ishikawa Japan

This study aimed at examining the differences in leg strength and activities of daily living (ADL) ability among groups with various knee problems. The subjects consisted of 328 elderly females who were classified into three groups: those without knee pain or a knee disorder, those with knee pain, and those with a knee disorder. The subjects took a knee extension strength test and an ADL survey. Knee extension strength and ADL scores (total score and each domain score of the motions of locomotion, posture change, stability, and manipulation) were selected as the evaluation parameters. The knee extension strength, total ADL score and each domain score of the motions of locomotion, posture change, and stability ranged from low to high in the following order: the group with a knee disorder, the group with knee pain, and the group without pain or a knee disorder. Moreover, manipulation scores were significantly inferior in the group with a knee disorder compared with the other two groups. In conclusion, the female elderly with knee pain or a knee disorder have inferior knee extension strength and ADL with respect to the motions of locomotion, posture change and stability. In addition, with regard toknee extension strength with respect to theabove three motions, the elderly with a knee disorder have inferior scores when compared with the elderly who have only knee pain;thus, they find it difficult to perform activities involving the knee joints.

关键词： Knee Joint Pain Knee Joint Disorder Knee Extension Strength ADL Female Elderly

Defecation disorders are crucial sequelae that impairs the quality of life of patients after conventional gastrectomy

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World Journal of Gastrointestinal Surgery 2021年第11期13卷 1484-1496页

作者： Koji Nakada Masami Ikeda Masazumi takahashi shinichi Kinami Masashi Yoshida Yoshikazu Uenosono Masanori Terashima Atsushi Oshio Yasuhiro Kodera University School of Medicine Tokyo 105-8461Japan Department of Surgery Asama General HospitalSaku 385-0022Japan Division of Gastroenterological Surgery Yokohama Municipal Citizen’s HospitalYokohama 240-8555Japan Department of Surgical Oncology Kanazawa Medical SchoolKanazawa 920-0293Japan Department of Surgery International University of Health and Welfare HospitalTochigi 329-2763Japan Department of Digestive Surgery Imamura General HospitalKagoshima 890-0064Japan Division of Gastric Surgery Shizuoka Cancer CenterShizuoka 411-8777Japan Faculty of Letters Arts and SciencesWaseda UniversityTokyo 169-8050Japan Department of Gastroenterological Surgery Nagoya University Graduate School of MedicineNagoya 466-8550Japan

BACKGROUND Defecation disorders are obscure sequelae that occurs after gastrectomy,and its implication on daily lives of patients have not been sufficiently *** To examine the features of defecation disorders after gastrectomy and to explore its implication on daily lives of patients in a large cohort using the Postgast rectomy Syndrome Assessment Scale(PGSAS)-*** We conducted a nationwide multi-institutional study using PGSAS-45 to examine the prevalence of postgastrectomy syndrome and its impact on daily lives of patients after various types of *** were obtained from 2368 eligible patients at 52 institutions in *** these,1777 patients who underwent total gastrectomy(TG;n=393)or distal gastrectomy(DG;n=1384)were *** severity of defecation disorder symptoms,such as diarrhea and constipation,and their correlation with other postgastrectomy symptoms were *** importance of defecation disorder symptoms on the living states and quality of life(QOL)of postgastrectomy patients,and those clinical factors that affect the severity of defecation disorder symptoms were evaluated using multiple regression *** Among seven symptom subscales of PGSAS-45,the ranking of diarrhea was 4th in TG and 2nd in *** ranking of constipation was 5th in TG and 1st in *** symptoms that correlated well with diarrhea were dumping and indigestion in both TG and DG;while those with constipation were abdominal pain and mealrelated distress in TG,and were meal-related distress and indigestion in *** five main outcome measures(MOMs)of living status domain,constipation significantly impaired four MOMs,while diarrhea had no effect in *** diarrhea and constipation impaired most of five MOMs in *** six MOMs of QOL domain,diarrhea impaired one MOM,whereas constipation impaired all six MOMs in *** diarrhea and constipation equally impaired all MOMs in *** sex,younger age,division of the celiac branch of vagus nerv

关键词： Postgastrectomy syndrome Defecation disorders Quality of life Patientreported outcome measures Gastrectomy

Quality of life after total vs distal gastrectomy with Rouxen-Y reconstruction: Use of the Postgastrectomy Syndrome Assessment Scale-45

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World Journal of Gastroenterology 2017年第11期23卷 2068-2076页

作者： Masazumi takahashi Masanori Terashima Hiroshi Kawahira Eishi Nagai Yoshikazu Uenosono shinichi Kinami Yasuhiro Nagata Masashi Yoshida Keishiro Aoyagi Yasuhiro Kodera Koji Nakada Division of Gastroenterological Surgery Yokohama Municipal Citizen’s Hospital Division of Gastric Surgery Shizuoka Cancer Center Center for Frontier Medical Engineering Chiba University Department of Surgery and Science Graduate school of medicine Kyushu University Department of Digestive Surgery Kagoshima University Graduate School of Medicine Department of Surgical Oncology Kanazawa Medical School Center for Comprehensive Community Care Education Graduate School of Biomedical Sciences Nagasaki University Department of Surgery International University of Health and Welfare Hospital Department of Surgery Kurume University School of Medicine Department of Gastroenterological Surgery Nagoya University Graduate School of Medicine Department of Laboratory Medicine The Jikei University School of Medicine

AIM To investigate the detrimental impact of loss of reservoir capacity by comparing total gastrectomy(TGRY) and distal gastrectomy with the same Rouxen-Y(DGRY) reconstruction. The study was conducted using an integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale(PGSAS)-45, recently developed by the Japan Postgastrectomy Syndrome Working *** The PGSAS-45 comprises 8 items from the Short Form-8, 15 from the Gastrointestinal Symptom Rating Scale, and 22 newly selected items. Uni-and multivariate analysis was performed on 868 questionnaires completed by patients who underwent either TGRY(n = 393) or DGRY(n = 475) for stage I gastric cancer(52 institutions). Multivariate analysis weighed of six explanatory variables, including the type of gastrectomy(TGRY/DGRY), interval after surgery, age, gender, surgical approach(laparoscopic/open), and whether the celiac branch of the vagus nerve was preserved/divided on the quality of life(QOL).RESULTS The patients who underwent TGRY experienced the poorer QOL compared to DGRY in the 15 of 19 main outcome measures of PGSAS-45. Moreover, multiple regression analysis indicated that the type of gastrectomy, TGRY, most strongly and broadly impaired the postoperative QOL among six explanatory variables. CONCLUSION The results of the present study suggested that TGRY had a certain detrimental impact on the postoperative QOL, and the loss of reservoir capacity could be a major cause.

关键词： Postgastrectomy syndrome Quality of life Gastric cancer Gastrectomy Patient-reported outcome

Background factors influencing postgastrectomy syndromes after various types of gastrectomy

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World Journal of Clinical Cases 2018年第16期6卷 1111-1120页

作者： shinichi Kinami Masazumi takahashi Takashi Urushihara Masami Ikeda Masashi Yoshida Yoshikazu Uenosono Atsushi Oshio Yoshimi Suzukamo Masanori Terashima Yasuhiro Kodera Koji Nakada Department of Surgical Oncology Kanazawa Medical University Division of Gastroenterological Surgery Yokohama Municipal Citizen’s Hospital Department of Gastroenterological Breast and Transplant Surgery Hiroshima Prefectural Hospital Department of Surgery Asama General Hospital Department of Surgery International University of Health and Welfare Hospital Department of Surgery Imamura General Hospital Faculty of Letters Arts and Sciences Waseda University Department of Physical Medicine and Rehabilitation Tohoku University Graduate School of Medicine Division of Gastric Surgery Shizuoka Cancer Center Department of Gastroenterological Surgery Nagoya University Graduate School of Medicine Department of Laboratory Medicine The Jikei University Daisan Hospital

BACKGROUND Postgastrectomy syndromes(PGS) after curative gastrectomy for gastric cancer are influenced by not only gastrectomy type but also by background factors. Recently, a nationwide PGS study was performed using the Postgastrectomy Syndrome Assessment Scale-45(PGSAS-45) *** To determine the influence of each background factor on PGS for each gastrectomy type using PGS assessment study(PGSAS) data as an additional analysis. METHODS The data of 2368 patients were obtained from the PGSAS. This included patients undergoing distal gastrectomy(DG) with Billroth I reconstruction, DG with Roux-en-Y reconstruction, total gastrectomy with Roux-en-Y, proximal gastrectomy, pylorus-preserving gastrectomy(PPG), and local resection. Multiple regression analysis was performed to explore the independent effects of each background factor on the main outcome measures(MOMs) of PGSAS-45 for each gastrectomy type. The background factors included postoperative period, age, sex, surgical approach(laparoscopic or open), and the status of the celiac branch of the vagal *** The MOMs of DG and PPG were highly affected by background factors, whereas those of total gastrectomy with Roux-en-Y, proximal gastrectomy, and local resection were not. Worse PGS were found in females, whereas a longer postoperative period alleviated some of the MOMs. For DG and PPG, a laparoscopic approach and preservation of the celiac branch improved several *** Various background factors affected PGS, and their influence varied with the type of gastrectomy performed. Laparoscopic surgery and celiac branch preservation can improve PGS in patients undergoing DG and PPG.

关键词： Postgastrectomy syndrome Gastrectomy Gastric cancer Postgastrectomy Syndrome Assessment Scale-45