Retional management of patients with hepatic malignancies for redical massive hepatectomy - with special reference to metabolic internsive care besed on "Redox theory".
| Project/Area Number |
61480282
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Kyoto University |
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Principal Investigator |
OZAWA Kazue Kyoto University, Faculty of Medicine, 医学部, 教授 (00026858)
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| Co-Investigator(Kenkyū-buntansha) |
UKIKUSA Minoru Kyoto University, Faculty of Medicine, 医学部, 助手 (60168672)
KAMIYAMA Yasuo Kyoto University, Faculty of Medicine, 医学部, 講師 (90127069)
YAMAOKA Yoshio Kyoto University, Faculty of Medicine, 医学部, 助手 (90089102)
森 敬一郎 京都大学, 医学部, 助手 (80159186)
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| Project Period (FY) |
1986 – 1987
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| Project Status |
Completed (Fiscal Year 1987)
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| Budget Amount *help |
¥6,500,000 (Direct Cost: ¥6,500,000)
Fiscal Year 1987: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1986: ¥6,000,000 (Direct Cost: ¥6,000,000)
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| Keywords | Blood detone body ratio / Massive hepatectomy / Metabolic intensive care / 肝癌 / 肝ミトコンドリア / チトクロムa / 肝切除 |
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| Research Abstract |
1. Developement of a simplified and accurate method for the determination of blood-ketone-body ratio (acetoacetate/<beta>-hydroxybutyrate, BKBR) reflecting liver mitochondrial (NAD/NADH, Redox state): Frequent determinations of redox state in patients with hepatic malignancies dueing pre-, intra-, and postoperative period have become possible to prevent hepatic insufficiency after radical massive hepatectomy by the assaying BKBR.
2. Establishment of assay system for cytochrome exydase activity using small specimen of liver biopsy: Both the content and specific activity of cytochrome c oxydase in cirrhotic liver was increased as compared with non-cirrhotic liver. Preoperative evaluation of mitochondrial function became possible.
3. Proposal of "Redox tolerance test": During oral glucose tolerance test (75 gm) changes in blood sugar and BKBR were measured simultaneously. In the patients with lowered hepatic functional reserve, the increase in the blood sugar did not accompanied with that of BKBR as expected in patients without liver diseases. Preoperative evaluation of redox state was found to be possible.
4. Prevention of metabolic stress on liver mitochondria during massive hepatectomy by serial assay of BKBR: some drugs and surgical procedures were found to have an inhibitory effect on mitochondrial function leading to a decrease in BKBR during massive hepatectomy. Prevention of the decrease in BKBR during surgery was found to be crucial for the prevention of postoperative liver failure.
5. Introduction of extracorporeal circulation using Bio-Pump for massive hepatectomy: For the prevention of both decrease in BKBR and massive bleeding during surgery, application of Bio-Pump was found to be useful for a massive hepatectomy without any complications.
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Report
(2 results)
Research Products
(17 results)
