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Biomedical subjects

T Kiuchi

Publications and source records attributed to T Kiuchi.

At least 127 records · Page 7Linked to original sources
PubMed1990

Prognostic implications of postoperative suppression of arterial ketone body ratio: time factor involved in the suppression of hepatic mitochondrial oxidation-reduction state.

To determine the tolerance limit of the liver in the critically suppressed mitochondrial oxidation-reduction state, the arterial ketone body ratio (acetoacetate/3-hydroxybutyrate), which reflects hepatic mitochondrial oxidation-reduction potential, was measured 1319 times in 161 patients during the postoperative critical period. Because patients who showed arterial ketone body ratios between 0.40 and 0.25 had a higher incidence of postoperative complications than had those who showed ratios above 0.40, this was designated as the critical zone of the arterial ketone body ratio. When duration in the critical zone was less than 2 days, 90% of the patients were able to tolerate the condition and survive. By contrast, when an arterial ketone body ratio below 0.40 was prolonged for more than 5 days, there was a high incidence of multiple organ failure and a 100% mortality rate, with the average survival period after a 5-day suppression being estimated as 5.7 +/- 2.4 days. It is suggested that the arterial ketone body ratio in the critical zone must be returned to normal values within 2 days to obtain a good prognosis.

Adolescent↗
PubMed1990

Reduced arterial ketone body ratio during laparotomy: an evaluation of operative stress through the changes in hepatic mitochondrial redox potential.

The present article discusses the evaluation of surgical stress on the basis of the hepatic functional capacity of each patient. The changes in arterial blood ketone body ratio (KBR; acetoacetate/beta-hydroxybutyrate), which reflects hepatic mitochondrial redox potential, following intraoperative procedures were investigated in 60 laparotomy cases, including 30 cases with partial hepatectomy. The time course of changes in KBR was obtained by serial measurement during operation. The total area below the KBR level of 0.7 was defined as the hepatic stress score (HSS). HSS was significantly greater in the cases with hepatectomy (43.5 +/- 9.1; mean +/- SE) than in others (16.5 +/- 4.2; p less than 0.01). HSS in 13 patients accompanied by postoperative complications (60.4 +/- 17.7) was also significantly greater than that in the patients with uneventful postoperative courses (22.1 +/- 4.3; p less than 0.05). The former was also accompanied by significantly larger postoperative catabolic response preceding the clinical onset of complications (p less than 0.001). In the cases with uneventful postoperative courses, analysis of variance revealed that nitrogen balance and catabolic index in the first postoperative week were dependent on HSS negatively and positively, respectively (p less than 0.005), indicating a causative relationship between the suppression of hepatic energy metabolism during operation and the enhanced postoperative catabolic response. These results suggest that total surgical stress in major laparotomy can be quantitated and evaluated through the magnitude of decrease in hepatic mitochondrial redox potential, and that this evaluation may provide valuable information for intraoperative and postoperative patient care.

3-Hydroxybutyric Acid↗
PubMed1990

[Alteration of the gastric mucosal glycoprotein in stress].

Many studies have postulated the role of gastric acid and mucosal microcirculation in the development of gastric ulcer. We considered that gastric mucosal glycoprotein played one of the most important roles as the defensive factors of te gastric mucosa. The purpose of this study is to investigate te location and distribution of glycoprotein in the gastric mucosa in normal and stressful condition. Male Wistar rats, weighing 250 g were used as the experimental animals. Alternation and distribution of glycoprotein in the gastric mucosa were studied by light and electron microscopic examination employing HRP-labeled lectin such as PNA, DBA, ConA, RCA, SBA, WGA and UEA-1 as a parameter before and after the development of stress ulcer. Around Thirty percent scalding burn of the rat body surface area was created. At 2, 5 and 24 hours after burn induction, the gastric mucosa was examined. PNA-binding sites which were primarily localized to the generative cell zone in the control rat appeared to extend from the upper layer to the intermediate or the basal layer of the gastric mucosa in accordance with the development of stress ulcer after burn. Most of the binding sites was detected in the parietal cells particularly along microvilli in the intracellular secretory canaliculi. The tubulovesicular system in the parietal cells became stainable with PNA in the stress-loaded rats. Alternation and binding pattern of lectin, especially of PNA may indicate the local response of the parietal cells of the gastric mucosa against the stress.

Animals↗
PubMed1989

Dome-like expansive laminoplasty for the second cervical vertebra.

The second cervical vertebra (C2) is in a pivotal position for the alignment and stability of the cervical vertebrae as a whole. Since its spinal canal is wider at the cranial and narrower at the caudal end, a dome-like excision of the inner side of the spinal canal from the caudal toward the cranial end results in the decompression of the lesion, preserving the dorsal part of the C2. The authors performed this C2 dome-like expansive laminoplasty on 33 patients (25 cases of the ossification of the posterior longitudinal ligament, six of developmental spinal canal stenosis, and two of spondylosis) and kept them under follow-up observation, which ranged from 1 to 7 years (mean, 3.5 years). The result was satisfactory in terms of the decompression and stability of the cervical vertebrae: even 5 years after the operation, no osteogenesis was noted in the expanded spinal canal to induce compression again. It thus may be concluded that this method is good enough to replace conventional laminectomy.

Aged↗
PubMed1989

Orthotopic partial liver transplantation in dogs can be performed without cold perfusion of the donor liver. Evaluation of its feasibility in terms of energy metabolism.

To investigate the feasibility of obtaining grafts from living, genetically related adult donors without any complicated harvesting techniques, orthotopic partial liver transplantation (PLT) without cold perfusion of the donor graft was evaluated in beagles by assessing the graft viability using ketone body ratio (KBR). Ten PLT were performed under venovenous bypass. The left half of the donor liver was transected in situ followed by systemic heparinization, and immediately implanted with care taken to leave the recipient's inferior vena cava intact, and to maintain the normothermic state without cold perfusion. Four of ten dogs survived for 5 days or longer (longest survival was 9 days) and died of other causes than graft dysfunction. Four others died of thromboembolitic episode, accidental bleeding or technical failure. Two dogs died of graft dysfunction. The changes in KBR in 5 dogs without fatal complications after transplantation were maintained within normal range thereafter. These results suggest that the PLT without cold perfusion of donor graft is possible from the viewpoint of energy metabolism.

Animals↗
PubMed1988

Impairment of gastric microcirculation in stress.

Gastric mucosal blood flow and microvascular patterns were studied in normal and stressed rats. In addition, various regulating factors of gastric mucosal blood flow, such as autonomic nervous system and biogenic amines, were investigated by histochemical procedures. Gastric mucosal blood flow was determined by the hydrogen gas clearance method as well as the hydrogen gas electrolytic method, and the microvascular structure was observed by the infusion method with two-colored silicon rubber. The gastric mucosal blood flow decreased significantly in the early period after induction of burn stress. The incidence of acute gastric mucosal lesions had a highly correlative relation with the decrease in mucosal blood flow. Reduction of mucosal blood flow was consequently due to opening of an arteriovenous shunt and hyperpermeability of true capillaries. This hemodynamic change, regulated by biogenic amines and autonomic nerves, was followed by ischemia and congestion of the gastric mucosa. The results of these studies demonstrated the importance of defensive factors; that reduction of mucosal blood flow resulted in the sequence of events that led to formation of acute gastric mucosal lesions.

Animals↗
PubMed1988

[Metabolic intensive care based on the hepatic mitochondrial redox in hepatectomy].

Intraoperative stress (ISS) in hepatectomy was quantified by the serial measurement of blood ketone body ratio (KBR) during operation. ISS was closely related with the decrease in the postoperative KBR and an enhanced postoperative catabolism. Postoperative urinary 3-methylhistidine level was positively and serum retinol binding protein level was negatively correlated with ISS. Intraoperative stress was closely linked with the postoperative metabolic abnormalities. A key stone in the postoperative management in hepatectomy is to elevate KBR. Utilization of energy substrate in the remnant liver is determined by the KBR level. When the KBR is maintained at higher than 0.7, glucose is predominantly utilized, while free fatty acids utilization increases according to the decrease in the KBR. KBR can be an index in the nutritional support after hepatectomy.

Hepatectomy↗
PubMed1987

[The effect of tegafur suppository and glutathione in patients with gastric and colonic cancer with special reference to the histopathological anticancer effect].

The purpose of these studies is to evaluate the anticancerous effects of tegafur suppository and Glutathione (GSH) as enhanced drug and compare the difference of the histopathological effects and tissue concentration of 5-FU and FT-207 in gastric and colon cancer. Thirty three patients with gastric cancer and 17 with colon cancer were treated by tegafur suppository at a dose of 1,500 mg/day and GSH, 1,200 mg/day intravenously. These patients were clinically divided into two groups, one of which was treated with tegafur suppository (Group A) and another administered with suppository and GSH (Group B). Five-fluorouracil was measured by GC-MF method and FT-207 was also done by HPLC method. After surgery, relationship between tissue concentration of 5-FU and histopathological effects were investigated. In gastric cancer, 5-FU concentration in cancer tissue was significantly kept high level in cancer tissue in patients treated with tegafur and GSH (Group B). However, there was no same results in colon cancer. These results seemed to be the difference of organ specificity. According to histopathological studies, well differentiated adenocarcinoma including papillary carcinoma were markedly effective compared to poorly differentiated adenocarcinoma in both cancer. This difference of anticancerous effect was supposed to be microangiographically different of microvascular architecture and quantity of anticancerous agents in tumor.

Colonic Neoplasms↗