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Biomedical subjects

T Tobe

Publications and source records attributed to T Tobe.

At least 433 records · Page 24Linked to original sources
PubMed1983

Metabolic abnormalities associated with postoperative organ failure. A redox theory.

We studied metabolic abnormalities of postoperative organ failure in 55 patients and classified them into four groups according to the postoperative changes in the arterial blood-ketone body ratio (acetoacetic acid-beta-hydroxybutyric acid) reflecting hepatic mitochondrial redox potential: patients in group A had no decrease below 0.7, patients in group B had a transient decrease to 0.4, patients in group C had a progressive decrease to below 0.4, and patients in group D (terminal stage) had a decrease to below 0.25. All group A and B patients tolerated their operations well; the group C and D patients had multiple organ failure. In groups B, C, and D, plasma concentrations of alanine, proline, phenylalanine, and tyrosine were negatively correlated with the blood--ketone body ratio and the molar ratios between the plasma concentrations of branched-chain amino acids and aromatic amino acids were positively correlated with the blood--ketone body ratio. Hepatic energy deficit associated with decreasing blood-ketone body ratio may be the metabolic basis of postoperative organ failure.

3-Hydroxybutyric Acid↗
PubMed1983

Effect of synthetic chicken vasoactive intestinal peptide on pancreatic blood flow and on exocrine and endocrine secretions of the pancreas in dogs.

This study was undertaken to determine the effect of synthetic chicken vasoactive intestinal peptide (VIP) on pancreatic blood flow, exocrine and endocrine secretions of the pancreas, and biliary secretion in dogs. The effect of synthetic chicken VIP on pancreatic blood flow and systemic arterial pressure was identical to that of natural chicken VIP in dogs. The present study demonstrated that synthetic chicken VIP induces significant increases in pancreatic blood flow, pancreaticobiliary secretion, and blood levels of insulin and glucose in dogs. Both the volume of pancreatic juice and blood levels of insulin were increased in consonance with the increase of pancreatic blood flow. This study suggests that the stimulatory effects of synthetic chicken VIP on exocrine and endocrine secretions of the pancreas may be related to the increased pancreatic blood flow elicited by synthetic chicken VIP.

Animals↗
PubMed1983

Relationship between initial hepatic uptake of indocyanine green and hepatic energy status in hepatectomized rabbits.

The relationship between initial hepatic uptake of indocyanine green (ICG) and hepatic energy status was studied in about 70% hepatectomized rabbits. At 24 h after hepatectomy, the initial plasma disappearance rate (K) and the maximal removal rate (Rmax) of ICG fell to 27 and 26%, respectively, and the mitochondrial phosphorylative activity was enhanced maximally with a concomitant decrease in the energy charge ( (ATP+1/2ADP)/(ATP+ADP+AMP) ) level. Afterward, the initial reduction of ICG removal rate was followed by a rapid increase in week 1 and more gradual return to preoperative values by week 6 after hepatectomy. In the early period after hepatectomy (1-7 days), the mitochondrial phosphorylative activity was the higher the smaller the %K value was, while in the late period after hepatectomy (1-6 weeks), the mitochondrial phosphorylative activity remained unchanged irrespective of increasing %K. It is suggested that the mitochondrial phosphorylative activity may be a better guide to evaluate the functional status of the remnant liver than the initial hepatic uptake of ICG, especially in the early period after hepatoctomy.

Adenosine Triphosphate↗
PubMed1983

Current status of surgical therapy for primary liver cancer in Japan.

The current status of diagnosis and treatment of primary liver cancer in Japan and its problems are described. Most primary liver cancers in the Japanese prove to be hepatocellular carcinoma complicated with liver cirrhosis. Based on these characteristics, at least three factors are important for the diagnosis of early stage of liver cancer 1) follow-up of high risk individuals 2), alpha-fetoprotein screening, and 3), application of ultra sonography (US) or computerized tomography (CT) in suspected cases. With relation to surgery, the following two points should be considered; 1), complications of esophageal varices and 2), development of postoperative hepatic failure or multiple organ failure (MFO) after extensive resection.

Carcinoma, Hepatocellular↗
PubMed1983

Contribution of the arterial blood ketone body ratio to elevate plasma amino acids in hepatic encephalopathy of surgical patients.

To clarify the role of hepatic metabolic derangements in elevated plasma amino acid levels, the patterns of plasma amino acids in 17 surgical patients with hepatic failure were analyzed in relation to the blood ketone body ratio (acetoacetate to beta-hydroxybutyrate), which reflects the mitochondrial redox potential. The blood ketone body ratios were 0.49 in eight alert patients with hepatic failure and 0.28 in nine patients with grade IV hepatic coma, compared with values of 0.79 to 6.42 in patients with healthy livers. The plasma concentrations of alanine, proline, phenylalanine, and tyrosine were negatively correlated with the blood ketone body ratio. Elevations of alanine, phenylalanine, tyrosine, and glutamate were greater in comatose patients than in alert patients. Also, the molar ratios between the plasma concentrations of the branched-chain amino acid and the aromatic amino acids were positively correlated with the blood ketone body ratio (r = 0.78, p less than 0.0001). We suggest that a reduced mitochondrial redox potential, coupled with enhanced muscle breakdown, results in inhibition in the entrance of the amino acids into the Krebs' cycle and then the characteristic changes in the free amino acid patterns which result in hepatic coma.

Adult↗
PubMed1983

GABA, glutamic acid decarboxylase, and GABA transaminase levels in the myenteric plexus in the intestine of humans and other mammals.

Regional distribution of endogenous gamma-aminobutyric acid (GABA), its synthesizing enzyme, glutamic acid decarboxylase (GAD), and metabolic enzyme, GABA transaminase (GABA-T), were determined in the intestinal tract of guinea pigs and cats and the findings compared with the number of ganglion cells in Auerbach's plexus. There were positive correlations among the GABA contents and the numbers of neural cells of the plexus. The precise localization of GABA and GAD in individual layers (mucosa, circular and longitudinal muscles, and Auerbach's plexus) in the human and cat colon was also determined. The endogenous GABA contents and GAD activity were the highest in Auerbach's plexus in tissues of both species. These results indicate that GABA is synthesized and localized in Auerbach's plexus and probably plays a significant role in the enteric nervous system.

4-Aminobutyrate Transaminase↗
PubMed1983

Postoperative prognosis as related to blood ketone body ratios in hepatectomized patients.

20 hepatectomized patients, both cirrhotic and noncirrhotic, were studied for the postoperative changes in the arterial blood ketone body ratio and standard liver function tests. It was found that serum enzyme activities, total protein, albumin, total bilirubin, total cholesterol and prothrombin time were less reliable direct indicators of the onset of postoperative hepatic insufficiency than the arterial blood ketone body ratio, which reflects the oxidoreduction state of liver mitochondria. The hepatectomized patients were classified into three groups according to the postoperative changes in the blood ketone body ratio. In the 8 patients of group A, the blood ketone body ratio did not decrease to below 0.7. In the 7 patients of group B, the blood ketone body ratio decreased transiently to 0.4-0.7 and then increased to over 0.7. In the 5 patients of group C, the blood ketone body ratio decreased irreversibly to below 0.4. There were few postoperative complications in group A. In group B, while a variety of complications occurred, they were ameliorated concomitantly with the restoration of the blood ketone body ratio. All group C patients died of multiple organ failure. It is proposed that the arterial blood ketone body ratio is a new and practical approach which enables more effective postoperative management by the accurate evaluation of hepatic functional reserve after hepatectomy.

Aged↗
PubMed1983

[Mucosal hyperplasia of the ileum after subtotal colectomy in rats].

To evaluate factors contributing to ileal mucosal hyperplasia following extensive colectomy, the following three models were designed in rats: Subtotal colectomy and end-to-end ileoproctostomy; retransection of the terminal ileum with end-to-side proximal-ileoproctostomy (colectomy group), End-to-side ileoproctostomy without colectomy (bypass group), and End-to-side ileocecostomy (control group). In all groups the terminal ileum was left out of the intestinal stream as defunctionalized segments. Specimens were obtained from the terminal ileum during operation and from both the functioning and the defunctionalized segments at various intervals postoperatively. The mucosal hyperplasia was evaluated by measuring eight variables including numbers of villi around the bowel circumference, villous height, crypt depth, total mucosal thickness, epithelial cell counts per villus, DNA contents per unit length of the bowel and radioactivity of incorporated 3H-thymidine as well as DNA specific activity. The results showed that marked mucosal hyperplasia of the functioning segments was noted in all groups, and that mucosal hyperplasia was also observed in defunctionalized segments of colectomized rats, but not in those of both bypass rats and control. These findings were statistically confirmed by analysis of variance. It was concluded that although intraluminal factors played an important role in mucosal hyperplasia of the ileum following extensive colectomy, humoral factors might be also involved in intestinal adaptation.

Animals↗
PubMed1983

Impaired glucose tolerance related to changes in the energy metabolism of the remnant liver after major hepatic resection.

In 70% hepatectomized rabbits, the glucose tolerance patterns after an oral glucose load were characterized by a longstanding increase of blood glucose for more than 180 min (a linear pattern) at 24 hr after hepatectomy and by a return toward normal range within 180 min (a parabolic pattern) at 96 hr later. At the linear stage, the concentrations of pyruvate and lactate of the remnant liver increased to 192% and 203%, respectively, of sham-operated controls at 1 hr after an oral glucose load. At 3 hours after glucose load, the concentrations of glucose-6-phosphate, fructose-6-phosphate, pyruvate, and lactate increased to 191%, 192%, 174% and 298%, respectively. By contrast, at the parabolic stage, no significant changes were observed. On the other hand, the energy charge level of the remnant liver decreased to 0.767 at the linear stage and returned to near normal levels at the parabolic stage. The ketone body ratio (acetoacetate/beta-hydroxybutyrate) in the arterial blood decreased to 0.415 at the linear stage, concomitant with the increase in total ketone body and NEFA concentrations, and returned to near normal levels at the parabolic stage. These findings suggest that the reduced mitochondrial redox potential, reflected by the decrease in ketone body ratio, inhibits pyruvate dehydrogenase. This prevents the entrance of pyruvate into the Krebs cycle and results in the inhibition of glucose oxidation, leading to a linear pattern after an oral glucose load.

Animals↗