Publications by authors named "Shintaro Sakurai"

Article Synopsis
  • Imeglimin, a new antidiabetic medication, was tested as an add-on therapy to metformin in patients with type 2 diabetes to see how it affects glucose levels and variability over 24 hours.
  • The study involved 30 patients using continuous glucose monitoring (CGM) for 14 days, with imeglimin introduced on day 7, measuring effects before and after treatment.
  • Results showed a significant decrease in 24-hour average glucose levels and increased time spent within the target glucose range, indicating improved glycemic control and variability with imeglimin addition, especially in those with higher baseline HDL cholesterol levels.
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Aims/introduction: In patients with diabetes, obesity is an aggravating factor for glycemic control and its vascular complications. However, the psychological and behavioral characteristics of those patients with obesity have not been fully clarified. This study investigated eating and coping behavior, personality traits, quality of life (QOL), and depression status in patients with diabetes with or without obesity.

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Unlabelled: Immune cell function is impaired in hyperglycemic patients with diabetes but thought to improve with normalization of blood glucose levels. In this study, we hypothesized that this improvement might involve changes in T cell function. We compared the peripheral T cell markers between the people with and without type 2 diabetes (T2D) admitted to our hospital for glycemic control, and then in patients with T2D before and after the improvement of hyperglycemia by inpatient treatment.

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Article Synopsis
  • A 47-year-old woman with myotonic dystrophy experienced poor glycemic control despite treatment with pioglitazone and insulin after a traumatic injury.
  • The addition of a GLP-1 receptor agonist significantly improved her blood sugar levels, allowing for the eventual withdrawal of insulin.
  • Genetic testing revealed a specific variant in the GLP1R gene, commonly found in Asia, which enhances insulin production in response to GLP-1 treatment, marking a unique case of myotonic dystrophy linked to this gene polymorphism in Japan.
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Purpose: Despite the widespread of ventral hernia repairs globally, the approach method, dissection planes, defect closure, and the choice and placement layer of mesh are an ongoing debate. We reported the details of surgical techniques, safety and feasibility for robot-assisted transabdominal transversalis fascial and preperitoneal repair (R-TATFPP) for small ventral hernia.

Methods: This study included 5 cases of R-TATFPP repair among 22 cases performed by robot-assisted ventral hernia repair from 2018 to 2023 with the approval of the Institutional Review Board at St.

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Background: To investigate effects of empagliflozin on plasma amino acids in people with type 2 diabetes.

Research Design And Methods: In a randomized, active-controlled, open-label trial, 58 patients with type 2 diabetes were randomized to 10 mg/day empagliflozin ( = 29) or standard treatment without empagliflozin (control group,  = 29) and treated for 12 weeks. We obtained blood samples at baseline and 12 weeks and assessed the plasma amino acid profile by liquid chromatography-mass spectrometry liquid chromatography.

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Aims: To investigate whether higher serum CCL11/Eotaxin-1, a biomarker for aging and neurodegenerative and neuroinflammatory disorders, is associated with diabetic sensorimotor polyneuropathy (DSPN), peripheral nerve dysfunction, and cardiac autonomic neuropathy in people with type 2 diabetes.

Methods: This cross-sectional study included 106 patients with type 2 diabetes and 40 healthy controls, matched for the age and sex distribution of the diabetes group as a whole. The CC chemokines CCL11/Eotaxin-1 and CCL22/MDC were measured in fasting serum samples.

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Non-alcoholic fatty liver disease (NAFLD) is increasing globally, and seeking therapeutic molecule targets is urgent. Several studies have demonstrated that IL-33 plays an important role in the progression of Non-alcoholic steatohepatitis (NASH) with fibrosis and the proliferation of hepatocellular carcinoma (HCC). However, whether the inhibition of IL-33 signaling prevents NAFLD from progressing to NASH and HCC has not been clarified.

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Objective: Cardiac autonomic neuropathy (CAN) is an independent risk factor for cardiovascular mortality and also is associated with a high risk of lethal arrhythmias and sudden death in people with type 1 or 2 diabetes. Heart rate variability (HRV) is an index of cardiac autonomic function. To investigate the relationship between HRV and arterial stiffness evaluated by the cardio-ankle vascular index (CAVI), a relatively new marker for arterial stiffness and a predictor of cardiovascular disease, in patients with type 2 diabetes.

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Nonalcoholic fatty liver disease (NAFLD) is an emerging worldwide health concern. The disease may involve immune cells including T cells, but little is known about the role(s) of the innate-like T cells in the liver. Furthermore, the most abundant innate-like T cells in the human liver are mucosal-associated invariant T (MAIT) cells, but the involvement of MAIT cells in NAFLD remains largely unexplored because of their paucity in mice.

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Aims: To investigate synergistic effects of liver fibrosis evaluated by FibroScan and sarcopenia on endothelial function and arterial stiffness in patients with type 2 diabetes.

Methods: This cross-sectional study evaluated liver fibrosis (LF) and sarcopenia in 115 patients with type 2 diabetes. LF was assessed as the liver stiffness measurement (LSM) in transient elastography (FibroScan) and was defined as an LSM greater than or equal to 8.

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Objective: We investigated longitudinal changes in circulating CD4 and CD8 T cells positive for programed cell death protein-1 (PD-1) and in other subsets of CD4 T cells in untreated hyperthyroid patients with Graves' disease after treatment with methimazole (MMI).

Design And Patients: The study included 18 untreated hyperthyroid patients with Graves' disease and 18 age-matched controls. Before and after 12-week treatment with MMI, we used flow cytometry to measure circulating PD-1  D4 and PD-1 CD8+ T cells and subsets of CD4 T cells in peripheral blood, as well as serum levels of chemokines related to T-helper type 1 (Th-1) and Th-2 cells.

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Article Synopsis
  • A 38-year-old woman developed severe hypothyroidism after radioactive iodine treatment for Graves' disease, continuing to have high TSH levels despite being on a high dose of levothyroxine (L-T4).
  • During hospitalization, it was discovered that she had lactose intolerance, which was likely hindering her absorption of the L-T4 tablets.
  • After switching her medication from L-T4 tablets to a powder formulation at the same dose, her thyroid hormone levels normalized, illustrating the impact of absorption issues on her treatment.
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Article Synopsis
  • Pancytopenia, a condition of low blood cell counts, can be caused by malnutrition after gastric bypass and is rare after sleeve gastrectomy.
  • A 35-year-old patient developed severe macrocytic anemia, leukopenia, and thrombocytopenia one year post-sleeve gastrectomy due to insufficient nutrient intake.
  • Tests revealed decreased haptoglobin, indicating hemolysis, and the presence of IgM and IgG antibodies against parvovirus B19, suggesting that this viral infection may have contributed to the patient's worsening anemia after surgery.
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Aim: To investigate acute effects of add-on therapy with the sodium glucose co-transporter 2 inhibitor tofogliflozin to dipeptidyl peptidase (DPP)-4 inhibitors on 24-hours glucose profile and glycaemic variability evaluated by continuous glucose monitoring (CGM) in patients with type 2 diabetes.

Patients And Methods: We studied 17 patients with type 2 diabetes who were hospitalised for glycaemic control. CGM was performed for 7 consecutive days in the last week of hospitalization.

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Aim: To investigate the relationship in people with type 2 diabetes between serum soluble dipeptidyl peptidase-4 (sDDP-4) and degree of liver fibrosis assessed as the liver stiffness measurement (LSM) and FAST (FibroScan-AST) score, both of which were measured by transient elastography (FibroScan).

Subjects And Methods: In this cross-sectional study, we examined 115 patients with type 2 diabetes. With transient elastography (FibroScan), we assessed the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) as measures of hepatic steatosis and liver fibrosis, respectively.

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Article Synopsis
  • Empagliflozin, an SGLT2 inhibitor, is shown to increase serum HDL-cholesterol levels and campesterol as a marker of cholesterol absorption in patients with type 2 diabetes.
  • In a study with 51 participants, those taking empagliflozin experienced significant increases in HDL-c and campesterol after 12 weeks, while standard therapy did not yield similar changes.
  • The findings suggest that empagliflozin may affect cholesterol metabolism by enhancing cholesterol absorption, particularly in patients not taking statins, as indicated by a decrease in lathosterol levels.
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Article Synopsis
  • - A single genetic change in the ARMC5 gene can lead to primary bilateral macronodular adrenal hyperplasia (PBMAH) and Cushing's syndrome when the second copy of the gene is altered later, known as the second hit.
  • - A case study of a 65-year-old woman with PBMAH revealed she had a specific genetic alteration in ARMC5 and also developed meningioma due to a loss of the unaffected gene copy.
  • - The findings suggest that mutations in ARMC5 might increase the risk of both PBMAH and meningioma through a two-hit genetic mechanism, although this connection needs further confirmation.
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We experienced two cases of dipeptidyl peptidase-4 (DPP-4) inhibitor-associated bullous pemphigoid (BP) showing an unfavorable course despite its discontinuation. Clinicians should carefully monitor the course of DPP-4 inhibitor-associated BP even after withdrawal of DPP-4 inhibitor therapy, especially in very elderly patients.

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Article Synopsis
  • The study aimed to investigate the effects of empagliflozin, an SGLT2 inhibitor, on the levels of plasminogen activator inhibitor-1 (PAI-1) and fibrinolytic activity in type 2 diabetes patients, as elevated PAI-1 is linked to vascular diseases like heart disease and stroke.
  • In a trial with 51 patients, those receiving empagliflozin experienced significant reductions in body weight, visceral fat, and PAI-1 levels compared to a control group on standard therapy over 12 weeks.
  • The results suggested that the reduction in PAI-1 was related to weight loss and changes in serum leptin levels, indicating that empagliflozin may
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Background: Dipeptidyl peptidase-4 (DPP-4) rapidly inactivates incretin hormones and several chemokines, thus influencing chemokine function. There have recently been several reports that DPP-4 inhibitor therapy is associated with an increased risk of bullous pemphigoid (BP), an autoimmune skin disease. Previous studies have demonstrated an increase of CCL11/Eotaxin, a DPP-4 substrate, in serum and blister fluid from patients with BP.

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Background: Adefovir dipivoxil is a nucleotide analogue that is approved for treatment of chronic hepatitis B. Adefovir dipivoxil is associated with proximal tubular dysfunction, resulting in Fanconi syndrome, which can cause secondary hypophosphatemic osteomalacia. We describe a case of a patient with hypophosphatemic osteomalacia secondary to Fanconi syndrome induced by adefovir dipivoxil concomitantly with osteoporosis in whom clinical symptoms were improved by adding denosumab (a human monoclonal antibody targeting the receptor activator of nuclear factor-κB ligand) to preceding administration of vitamin D.

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Aims: Soluble dipeptidyl peptidase-4 (sDPP-4) is secreted by hepatocytes and induces adipose tissue inflammation and insulin resistance. Sodium-glucose co-transporter-2 (SGLT2) inhibitors can improve hepatic steatosis by inhibiting hepatic de novo lipogenesis. We investigated the effects of dapagliflozin (an SGLT2 inhibitor) on serum levels of sDPP-4 in patients with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD).

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A 56-year-old man noted sudden onset of headache, fever, right pupil-spared oculomotor nerve palsy and consciousness disturbance. Swelling of pituitary with T high intensity on brain MRI suggested the diagnosis of pituitary apoplexy. Considering significant decrease of pituitary anterior lobe hormone and central diabetes insipidus, high dose of hydrocortisone was administered.

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Cellulose paper is an attractive substrate for paper electronics because of its advantages of flexibility, biodegradability, easy incorporation into composites, low cost and eco-friendliness. However, the micrometre-sized pores of cellulose paper make robust/conductive films difficult to deposit onto its surface from metal-nanoparticle-based inks. We developed a Cu-based composite ink to deposit conductive Cu films onto cellulose paper via low-temperature sintering in air.

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