| Project/Area Number |
11671307
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | The University of Tokyo |
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Principal Investigator |
MIYIRI Takeshi (2000) MO Faculty of medicine, University of Tokyo Assistant, 医学部・附属病院, 助手 (50302683)
前田 克英 (1999) 東京大学, 医学部・附属病院, 助手 (40313150)
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| Co-Investigator(Kenkyū-buntansha) |
MORAKAMI Arata MO Faculty of medicine, University of Tokyo Lecturer, 医学部・附属病院, 講師 (70190874)
TAKAMOTO Shinichi MO Faculty of medicine, University of Tokyo Professor, 医学部・附属病院, 教授 (60137833)
宮入 剛 東京大学, 医学部・附属病院, 助手 (50302683)
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| Project Period (FY) |
1999 – 2000
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| Project Status |
Completed (Fiscal Year 2000)
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| Budget Amount *help |
¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 2000: ¥1,500,000 (Direct Cost: ¥1,500,000)
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| Keywords | retrograde cerebral perfusion / deep hypothermia / carbon droxide / alpha-stat / pH-stat / NO_x / pH-stat / 胸部大動脈 / 脳保護 / 逆行性脳灌流 / α-stat |
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| Research Abstract |
(Background and Objective) Many forms of physiologic intervention have been assessed in attempts to improve the outcome of patients undergoing deep hypothermic retrograde cerebral perfusion (RCP). However, there is still no conclusive opinion about the proper arterial gas management of carbon dioxide (CO_2). (Objective) The aim of this study is to determine if acute manipulations of CO2 can be effective for brain protection in terms of cerebral blood flow (CBF) of the cortex, oxygen and NO metabolism, and the distribution of regional blood flow in the brain. (Methods) : Fifteen anesthetized dogs on cardiopulmonary bypass (CPB) were cooled to 18°C under alpha-stat management and underwent RCP for 90 min under alpha-stat (RCP-alpha), pH-stat (RCP-pH), or deep hypothermic (18° C) antegrade CPBunder alpha-stat (antegrade). RCP flow was regulated to a sagittal sinus pressure of around 25 mmHg. CBF was monitored using a laser Doppler flowmeter. Serial analyses of blood gas and NOx were made
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in samples from the inflow to, and the outflow from the brain. CBF, cerebral, metabolic rate for oxygen (CMRO2) and NOx were compared as percentages of the control levels. Regional blood flow in the brain was measured by colored microsphere. (Rasults) : O_2 content of the inflow did not differ between the RCP groups at any time during the study period. CBF and CMRO2 were significantly higher for RCP-pH than for RCP-alpha, although the difference between RCP-pH and antegrade was not significant. The plasma NOx level in the outflow was significantly lower for RCP-pH than for RCP-alpha. Regional blood flow was not significantly different between the sites in the brain under these CO2 managements. (Comment) CO_2 management is crucial for brain protection under deep hypothermic RCP.This study revealed that attenuation of the NOx level played a role in protection from NO-induced neuronal damage. In addition, it is possible that the increase of CBF under pH-stat will result in attenuation of NOx in the outflow. Under RCP.pH-stat was considered to be better than alpha-stat for cerebral protection in terms of CBF, oxygen and NO metabolism. Less
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