| Project/Area Number |
06670593
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Gastroenterology
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| Research Institution | Kurume University |
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Principal Investigator |
TOYONAGA Atsushi Kurume University Medical professor, 医学部, 教授 (00098881)
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| Co-Investigator(Kenkyū-buntansha) |
OHO Kazuhiko Kurume University Medical resident, 医学部, 助手 (80248369)
IKEGAMI Motoki Kurume University Medical resident, 医学部, 助手 (70248368)
SUMINO Michihiro Kurume University Medical resident, 医学部, 助手 (30196919)
IWAO Tadashi Kurume University Medical resident, 医学部, 助手 (10193715)
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| Project Period (FY) |
1994 – 1995
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| Project Status |
Completed (Fiscal Year 1995)
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| Budget Amount *help |
¥2,100,000 (Direct Cost: ¥2,100,000)
Fiscal Year 1995: ¥400,000 (Direct Cost: ¥400,000)
Fiscal Year 1994: ¥1,700,000 (Direct Cost: ¥1,700,000)
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| Keywords | Portal hypertension / Congestive gastropathy / Portal hemodynamics / Vasopressin / Nitroglycerin / Isosorbide Dinitrate / Propranolol / Teprenylaceton / バソプレッシン / Portal hypertensive gastropathy(PHG) / レーザードップラー法 |
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| Research Abstract |
Non-erosive gastric mucosal lesions are frequently observed in patients with portal hypertension, and represents acute or chronic GI bleeding. This unique condition has been termed as "portal hypertensive gastropathy (PHG)" or "congestive gastropathy. Recent series of studies have shown that the microcirculation on gastric mucosa in patients with PHG is impaired, and that this gives rise to bleeding and gastric ulcer complications. Thus our studies were conducted focusing on management of PHG.
1. Portal hemodynamics : In patients with PHG,poorly developed extravariceal portosystemic shunts with higher portal pressure can be expected, in whom a lower gastric mucosal perfusion could be found. The fact that PHG after aclerotherapy shows no aggravation in patients with major extravariceal portosystemic shunt can support this hypothesis.
2. Vasopressin+Nicardipine induced a significant reduction in both free portal pressure and the portal venous pressure gradient. These effects were similar to the changes with vasopressin alone. Vasopressin decreased both hepatic blood flow and intrinsic clearance of indocyanine green. Consequently the additio of nicardipine improves hepatic impairment induced by Vasopressin but causes no further reduction on portal pressure.
3. Nitroglycerin reduces portal venous pressure in cirrhotic patients and portal hypertension, particularly in those with major porto-systemic collaterals, and reduces the congestion of the gastric mucosa in patients with portal hypertension.
4. In the idea of liver-stomach correlation, local treatment for gastric mucosa is also important. Teprenylaceton caused significant mucous production and cetraxate produced significant increase of gastric mucosal perfusion.
Combination of portal pressure lowering drugs and local drugs for gastric mucosa is relevant subject for further evaluation.
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