| Project/Area Number |
60570603
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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 |
General surgery
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| Research Institution | TEIKYO UNIVERSITY |
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Principal Investigator |
KOBAYASHI Kunio (1986) TEIKYO NIVERSITY, ASSOCIATE PROFESSOR, 医学部, 助教授 (80082147)
小林 国男 (1985) 帝京大学, 医学部, 助教授
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| Co-Investigator(Kenkyū-buntansha) |
SUZUKI Hiromasa TEIKYO UNIVERSITY, ASSISTANT, 医学部, 助手 (00187759)
YOKOO Naoki TEIKYO UNIVERSITY, ASSISTANT, 医学部, 助手 (90191494)
HASEBE Masaharu TEIKYO UNIVERSITY, ASSISTANT PROFESSOR, 医学部, 講師 (00082264)
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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 |
¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 1986: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1985: ¥1,600,000 (Direct Cost: ¥1,600,000)
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| Keywords | Surgical Stress / Energy Metabolism / 高カロリー輸液 |
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| Research Abstract |
WE INVESTIGATED THE EFFECTS OF FAT EMULSIONS IN SEPTIC DOGS. SEPSIS WAS INDUCED BY CECAL LIGATION AND PUNCTURE IN FOUR GROUPS OF ADULT MONGREL DOGS. EACH GROUP RECEIVED ONE OF FOLLOWING TPN REGIMENS FOR 48 HOURS POSTOPERATIVELY, AND THEN NITROGEN BALANCE (NB), ENERGY EXPENDITURE (EE), <CO_2> PRODUCTION, ARTERIAL KETONE BODY RATIO (AKBR:ACETOACETATE/ <beta> -HYDROXYBUTYRATE) AND HEPATIC ENERGY CHARGE (ATP+0.5 ADP/ATP+ADP+AMP) WERE MEASURED. ALL GROUPS RECEIVED 150% CALORIES OF PREOPERATIVE EE AND KCAL/N WERE DETERMINED AT 138. GROUP-1 RECEIVED 100% OF NONPROTEIN CALORIES AS GLUCOSE (D100). GROUPS-2-4 WERE GIVEN 20% (D80), 50% (D50) OR 80% (D20) OF NONPROTEIN CALORIES AS LIPID RESPECTIVELY.
THE MORTALITY RATE OF EACH GROUP AFTER 48 HOURS ON TPN WERE 10% (D100), 18% ( D80), 27% (D50) AND 33% (D20) RESPECTIVELY. WHILE NB WERE NEGATIVE IN ALL GROUPS, D80 SHOWED RELATIVELY GOOD RESULT. RESPIRATORY QUOTIENT WERE LOWERED SIGNIFICANTLY (P<0.05) AS LIPID FRACTION INCREASED (D100:0.98 <-!+> 0.05, D80;0.89 <-!+> 0.03, D50;0.87 <-!+> 0.03, D20;0.78 <-!+> 0.02). EC WHICH INDICATED HEPATIC ENERGY LEVEL SHOWED SIGNIFICANT DECREASE IN D50 AND D20 (0.805 <-!+> 0.017 AND 0.796 <-!+> 0.012 RESPECTIVELY) COMPARED TO D100 (0.855 <-!+> 0.009), WHEREAS D80 REMAINED MILD DECREASE (0.827 <-!+> 0.011). FURTHERMORE, AKBR WHICH IS KNOWN TO REFLECT THE HEPATIC MITOCHONDRIAL FUNCTION WERE LOWER IN D50 AND D20 THAN D100 AND D80.
THESE RESULTS CLEARLY DEMONSTRATE THAT ADMINISTRATION OF FAT EMULSIONS MORE THAN 50% OF NONPROTEIN CALORIES IS DISADVANTAGEOUS FROM THE VIEWPOINT OF HEPATIC ENERGY METABOLISM AS SHOWN IN DECREASE OF EC AND AKBR, THOUGH IT HAS SOME ADVANTAGE ON LIGHTENING OF THE RESPIRATORY LOADING. AND IT WAS THOUGHT THAT HIGH MORTALITY RATE IN D50 AND D20 MAY BE ATTRIBUTED TO THE DISORDERED HEPATIC ENERGY METABOLISM BY FAT EMULSIONS.
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