Junichi Katoh

Prediction of functional outcome after stroke rehabilitation.

ObjectiveThe purpose of this study is to identify predictors of functional outcome after acute stroke inpatient rehabilitation using raw Functional Independence Measure (FIMTM) total scores. DesignMultivariate analysis was performed on data collected retrospectively from stroke rehabilitation patients. Six independent variables were obtained from patients’ medical records. ResultsThe FIM total scores at the time of discharge from the hospital correlated strongly with FIM total scores at the time of admission to the hospital and correlated negatively with age and OAI using the Spearman’s rank correlation method. The FIM total scores at the time of hospital admission were the best predictor of FIM total scores at the time of discharge from the hospital. However, the nature of the stroke, gender, and LOHS did not correlate with FIM total scores at the time of discharge from the hospital. ConclusionsBecause FIM total scores at the time of hospital admission and discharge are highly correlated, FIM total scores at the time of hospital admission can be used to establish a rehabilitation program, to inform the patient and family about the possibility of recovery, and to assess the amount and quality of care given in the home or discharge placement.

Fasting insulin and leptin serum levels are associated with systolic blood pressure independent of percentage body fat and body mass index.

OBJECTIVE To examine the relationship between leptin and insulin serum levels and systolic and diastolic blood pressure in young men. SETTING Kobe University of Mercantile Marine, Kobe, Japan. PARTICIPANTS One hundred and ninety-eight male students aged 18-20 years (comprising 100% of those eligible). DESIGN AND MEASUREMENTS A cross-sectional survey of a sample of male college students was performed, with measurements to include anthropometry, blood pressure and blood tests after overnight fasting. RESULTS Compared with 90 men with an optimal blood pressure, 56 men with high-normal and high blood pressure had an increase in body mass index (23.7 +/- 5.2 versus 20.4 +/- 2.2 kg/m2), percentage body fat (21.7 +/- 8.0 versus 16.3 +/- 4.2%) and serum leptin (3.7 +/- 4.7 versus 1.5 +/- 0.8 ng/ml). In addition, they had greater serum insulin (59 +/- 31 versus 43 +/- 12 pmol/l) despite there being no differences in plasma glucose, resulting in a reduction of the ratio of glucose to insulin (x 10(6)) (107 +/- 43 versus 126 +/-, which is an estimate of insulin sensitivity in a nondiabetic population. Furthermore, the 56 men had higher serum triglyceride levels, although there was no difference in low density lipoprotein-cholesterol and high density lipoprotein-cholesterol between men with optimal and high-normal plus high blood pressure. Similar differences were found between men in a top versus low tertile of systolic and diastolic blood pressure. In multiple regression analysis, both log leptin and log insulin emerged as determinants for systolic blood pressure independent of body mass index and percentage body fat, but an association with diastolic blood pressure was only shown for log leptin. CONCLUSION Hyperleptinemia and hyperinsulinemia may be regulators of arterial pressure, independent of body mass index or percentage body fat.

RESPONSE OF GLUTAMIC ACID DECARBOXYLASE TO GLUCOSE BUT NOT ARGININE IN ISLETS

This study examined responses of glutamic acid decarboxylase (GAD65) and gamma-aminobutyric acid (GABA) to glucose in pancreatic islets. Islets isolated from Wistar rats were cultured for the three days under different concentrations of glucose (5.6, 11.1 or 16.7 mM) or arginine (2 x 10(-1)-2 x 10(-4) mM) for different periods of time. The expression of GAD65 increased 3.8- and 4.5-fold with the elevation of glucose concentrations as well as the prolongation of culture periods of time, while it did not increase with arginine. GABA content of islets did not change in a range of 5.6 to 16.7 mM glucose. These results suggest that normalization of hyperglycemia would reduce the expression of the autoantigen in islets, which might prevent islets from further destruction. To the contrary, the persistent hyperglycemia could interfere with insulin synthesis not by change of GABA in islets but by the destruction of islets through GAD65 expression.

A convulsant, 3-mercaptopropionic acid, decreases the level of GABA in pancreatic islets of rat as well as that of brain

To investigate the properties of the gamma-aminobutyric acid (GABA) synthesizing enzyme, glutamate decarboxylase (GAD), in the brain and the pancreatic islets of the rat, GABA concentration in the brain and the pancreatic islets was measured after administration of 3-mercaptopropionic acid (3-MP) at 25 mg/kg intraperitoneally. Sixty minutes after the administration of 3-MP, GABA concentration in the hypothalamus, the superior colliculus and the hippocampus of the brain decreased by 20-30% and in the pancreatic islets by 35%. The activities of GAD in the pancreatic islets and brain can be modified by a convulsant, in this case 3-MP. These results suggest the properties of GAD may be similar in the pancreatic islets and brain.

A convulsant, 3-mercaptopropionic acid, decreases the level of GABA and GAD in rat pancreatic islets and brain.

To investigate the properties of the gamma-aminobutyric acid (GABA) synthesizing enzyme, glutamate decarboxylase (GAD), in the brain and the pancreatic islets of the rat, GABA concentration in the brain and the pancreatic islets was measured after intraperitoneal administration of 3-mercaptopropionic acid (3-MP) at 25 mg/kg. 60 min after the administration of 3-MP, GABA concentration in the hypothalamus, the superior colliculus and the hippocampus of the brain decreased by 20–30% and in the pancreatic islets by 35%. The concentration in the pancreatic acini did not change. Western blotting showed that GAD activity in the pancreatic islets decreased after administration of 3-MP compared to the control. The activity of GAD in the pancreatic islets as well as brain can be modified by a convulsant, in this case 3-MP. These results suggest the properties of GAD may be similar in the pancreatic islets and brain.

Physiological Aspects of GAD-GABA System in the Pancreatic Islet

In the pancreatic islet, which is non-neuronal, γ-aminobutyric acid (GABA) and its synthesizing enzyme, L-glutamate decarboxylase (GAD), are so high in concentration and activity respectively as in the brain, where GABA functions as an inhibitory neurotransmitter. This GABA may exert an inhibitory action on the secretion of somatostatin and glucagon possibly via GABAergic peri-insular neurons. Besides, the GAD-GABA system appears to be involved in insulin synthesis in the islet.