ノウソッチュウ シンダン ノ サイゼンセン

Stroke Care Unit （SCU） in Tokushima University Hospital has been opened since November １９９９. Patients with acute stroke in SCU were diagnosed by stroke MRI and biomarker immediately after their admission. Diffusion MRI could diagnose the ultra-acute ischemic and hemorrhagic lesion except brainstem ischemic lesion within ３ hrs after onset. Diffusion-Perfusion mismatch was useful to indicate intra-arterial thrombolytic therapy. ３T-MRI was introduced since March ２００４，and it can measured functional MR spectroscopy and tractography more quickly compared to １．５T-MRI. Plasma oxidized LDL in patients with acute cerebral infarction was significantly higher than that in healthy control and it became peak level during ３‐５ day after stroke onset. In conclusion, stroke MRI and plasma oxidized LDL are useful diagnostic tools for acute stroke

Metabolic role of the kidney in acute hepatic failure (Guanidino compounds and the metabolic relationship between the liver and kidney)

A metabolic relationship between the liver and kidney exists in conbination with the urea cycle. We found different concentrations of serum guandino compounds between patients with acute renal failure and those with acute hepatic failure. We made an experimental model of acute hepatic failure in rats by injecting 1,000 mg/kg of D-galctosamine i. p. and evaluated the metabolic changes in the liver and kidney by measuring guandino compound levels using high performance liquid chromatography. We concluded that when the urea cycle was disturbed, the metabolism in the kidney was activated, and the synthesis of GAA (guandino acetic acid) was accelerated for the purpose of excreting ammonium. Also, we thought it possible to evaluate the metabolic compensative ability of the kidney by determining (serum Arginine)/(serum GAA). In the liver and kidney of rats, we found high levels of GBA (guanidino butyric acid), the metabolic pathway of which is unknown. With the progress of liver damage, the release of GBA into the serum was observed