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Biomedical subjects

S Matsubara

Publications and source records attributed to S Matsubara.

435 records · Page 25Linked to original sources
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Temporary metabolic support by extracorporeal blood therapy for liver failure after surgery.

With the aim of temporarily assisting deterioration of liver function developing after surgery, extracorporeal blood purification therapy (EBPT) (plasma exchange and/or hemofiltration) was carried out in 26 postoperative patients. Initiation of EBPT was instituted according to the criteria of either a serum bilirubin greater than 15 mg/dl or Grade 2 or more coma. Plasma exchange was carried out 235 times in 23 patients and hemofiltration was performed 28 times for seven patients. In addition, hemodialysis and CAPD were linked in eight cases. Plasma exchange was found to control the progression of DIC and endotoxemia. Nine patients (35%) were weaned from EBPT. In the survivors the levels of blood ammonia and number of major complications were significantly lower compared to the nonsurvivors. Three patients treated only with hemofiltration were all lost. Among co-morbid factors present, incidences of renal failure, respiratory failure, and associated liver cirrhosis significantly increased poor clinical outcome on EBPT for postoperative liver failure.

Adolescent↗
PubMedDate not supplied

Fuel utilization and glucose hyperalimentation after liver resection.

Clinical studies and experiments in rats were carried out to elucidate changes in fuel utilization after hepatectomy. In addition, the effect of glucose hyperalimentation on energy metabolism in the liver remnant was studied. Respiratory quotient (RQ) and substrate oxidation rate for fat and glucose were evaluated by indirect calorimetry in eight patients who had undergone liver resection. Patients had a reduced nonprotein RQ of approximately 0.85 and a reduced ratio of glucose to fat oxidation of approximately 2.0 on the 1st and 2nd postoperative days. After 80% hepatectomy, rats received either 30 kcal.kg-1.day-1 (group 1) or 200 kcal.kg-1.day-1 (group 2) of glucose for 48 h. In both rat groups, hepatic mitochondrial ATP synthesis 12 and 24 h after hepatectomy was accelerated when palmitic acid was used as the substrate and suppressed when pyruvate was used compared with sham-operated groups. This suggests that the energy substrate of the remnant liver was principally fatty acids rather than glucose, which seems to occur also in humans. Hepatic energy charge was within normal limits in group 1 (0.862 +/- 0.008) but decreased significantly in group 2 (0.818 +/- 0.006, p < 0.01) 12 h after hepatectomy. An abundance of glucose in the early postoperative period therefore caused a hepatic energy derangement by suppressing endogenous fat oxidation. This suppression was corroborated by the findings of lower immunoreactive glucagon and nonesterified fatty acid concentration in group 2. Therefore, glucose hyperalimentation in the early postoperative period after liver resection is not recommended.

Adenosine Triphosphate↗