| Project/Area Number |
12671510
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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 |
Anesthesiology/Resuscitation studies
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| Research Institution | Kansai Medical University |
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Principal Investigator |
NAKATANI Toshio Kansai Medical University, Faculty of Medicine, Professor, 医学部, 教授 (70188978)
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| Co-Investigator(Kenkyū-buntansha) |
SHINYA Hiroshi Kansai Medical University, Faculty of Medicine, Instructor, 医学部, 助手 (90309229)
赤堀 道也 関西医科大学, 医学部, 助手 (80278605)
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| Project Period (FY) |
2000 – 2002
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| Project Status |
Completed (Fiscal Year 2002)
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| Budget Amount *help |
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 2002: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 2001: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 2000: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | arterial ketone body ratio(AKBR) / mitochondria / hepatocyte / energy generation / supernormal level / stress insult / hemorrhagic shock / severe sepsis / AKBR / 動脈血中ケトン体比 / 肝ミトコンドリア / 機能亢進 |
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| Research Abstract |
Arterial ketone body ratio(AKBR) which reflects hepatic mitochondrial redox status through arterial blood measurements was advocated in Japan, and has been widely determined in the fields of transplantation surgery, gastroentrological surgery, and emergency and critical care medicine. The lower limit of normal range of AKBR is considered to be 1.0. Various kinds of hepatic dysfunction occurs when AKBR is below the normal limit. On the other hand, when AKBR recovered to normal range, hepatic function was supposed to be recovered to normal.
However, supernormal level of AKBR elevating to 2.5 or higher were observed in many cases in critical care medicine. There has been no discussion on the meaning of supernormal level of AKBR. In this study, I have studied the occurrence and meaning of supernormal level of AKBR. In many cases with severe stress insult such as hemorrhagic shock and severe sepsis, decreased AKBR not only recovers to normal range but continue to rise to supernormal level. I have studied the meaning of the supernormal level of AKBR in relation to SOFA score which is widely accepted as a diagnostic criteria of multiple organ failure. It is revealed that in many cases with supernormal AKBR level, SOFA score was higher than 10 points indicating that MOF was still on-going. This indicates that hepatic mitochondria are under hyperfunction to enhance energy generation that meets to the increased energy demand during the phase with AKBR supernormal level. It was considered that supernormal AKBR level reflects enhanced hepatic mitochondrial function to compensate the insufficient recovery of hepatocyte energy level.
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