| Project/Area Number |
60304066
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| Research Category |
Grant-in-Aid for Co-operative Research (A)
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| Allocation Type | Single-year Grants |
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| Research Field |
General surgery
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| Research Institution | Kyoto University |
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Principal Investigator |
TOBE Takayoshi Faculty of Medicine, Kyoto University, 医学部, 教授 (70025641)
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| Co-Investigator(Kenkyū-buntansha) |
MUTO Terukazu Niigata University School of Medicine, 医学部, 教授 (80018308)
MORIOKA Yasuhiko Faculty of Medicine, Tokyo University, 医学部, 教授 (10048952)
MIZUMOTO Ryuji Mie University School of Medicine, 医学部, 教授 (00025561)
SUGAHARA Katsuhiko Yamanashi Medical University, 教授 (90009944)
ABE Osahiko Faculty of Medicine, Keiogijuku University, 医学部, 教授 (90051028)
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| Project Period (FY) |
1985 – 1986
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| Project Status |
Completed (Fiscal Year 1986)
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| Budget Amount *help |
¥7,500,000 (Direct Cost: ¥7,500,000)
Fiscal Year 1986: ¥3,200,000 (Direct Cost: ¥3,200,000)
Fiscal Year 1985: ¥4,300,000 (Direct Cost: ¥4,300,000)
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| Keywords | Multiple Organ Failure (MOF) / DIC / Massive Organ Resection / Respiratory and Circulatory Failure / Hepatic Failure / Obstructive Jaundice / 重症膵炎 / エンドトキシン |
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| Research Abstract |
Multiple organ failure (MOF) seen after operations is progressive and its prognosis is poor. This study was designed to clarify the mechanism of the development and pathophysiology of MOF and to seek for better treatment of MOF. As a result of a co-operative study from eight institutes, the following results were obtained. 1. DIC and MOF: DIC was one of the most important factors influencing MOF, often progressing in parallel with the degree of the pathological disturbances involving several organs. 2. Respiratory and circulatory failure and MOF: Thromboxane <A_2> was considered to be a mediator of respiratory and cardiac failure. The accumulation of neutrophils mediated by complement was one of the causes of respiratory failure. 3. MOF following esophagectomy: The lung is the initial site of organ failure following esophagectomy. Infection was the most important risk factor for the development of respiratory failure. In patients with sepsis, disturbances of glucose tolerance and abnor
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mal protein metabolism were also observed, suggesting that TPN is very important following operations. 4. Hepatic failure and MOF: Ischemia of the liver during operations and congestion of the bile due to severe postoperative infection were the major causes of hepatic failure, suggesting that lowered energy metabolism in the liver may be a risk factor for MOF. 5. Obstructive jaundice and MOF: One of the factors in obstructive jaundice induced MOF was the increase in immune complexes due to dysfunction of secretory IgA triggered by endotoxin. 6. Pancreatitis and MOF: Disturbances in the renal tubules caused by phospholipase <A_2> and the disturbance of the renal glomerulus and respiratory function were identified as a cause of acute pancreatitis inducing MOF. 7. MOF and nutrition: Glucose metabolism shifts to a hypermetabolic state during endotoxemia suggesting the importance of alimentation in MOF state. These studies are quite meaningful in that they have paved the way for a systemic study of the pathogenesis of MOF. Further systemic and detailed studies on each field will provide useful clue for future establishment of diagnostic criteria of MOF. Less
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