Developmet of Clye cleavano with near-infrared tissue spectroscopy

吲哚青绿在近红外区有805 nm的特定吸光度。因此，我们通过组织近红外光谱分析的多重曲线拟合分析，评估了吲哚青绿在排除氧合血红蛋白和脱氧血红蛋白后的吸光度，氧化和还原细胞色素c氧化酶和洗去肝脏成分的吸光度。用这种新的方法，我们用红细胞的血氧饱和度来评价组织氧合作用，用吲哚青绿给药后增加相的速率常数来评价吲哚青绿的跨膜转运，用降低相的速率常数来评价细胞内通过胆小管的转运和排泄。胆红素作为跨膜摄取吲哚青绿的竞争性抑制剂，可抑制给药后的增高期。秋水仙碱和哇巴因通过破坏肝细胞微管和抑制Na-K…而抑制下降时相胆小管细胞膜的ATPase较多。因此，这两个速率常数被证实是吲哚青经胆小管跨膜摄取和细胞内转运和排泄的指标。我们将这种方法应用于肝脏缺血再灌注损伤，结果表明，肝缺血再灌注损伤后肝细胞跨膜摄取受到损伤，但很快恢复，而细胞内转运和通过胆小管排泄的恶化持续时间更长。由于这些损伤与细胞内ATP的减少有关，因此这些损伤可能是由于细胞内钙代谢的恶化所致。此外，我们还使用这种方法进行了肝功能分区试验。我们同时测量了缺血叶和对照叶对吲哚青绿的摄取和排泄。本研究表明，非缺血叶在染料排泄方面受到对侧缺血叶的影响，提示在肝切除术中应尽量避免缺血性损害。较少

Indocyanine green has a specific absorbance at 805nm in the near-infrared light region. Therefore, we have evaluated absorbance of indocyanine green after excluding oxy-hemoglobin and deoxyhemoglobin, oxidized and reduced cytochrome c oxidase and washed out liver components by multiple curve fitting analysis with tissue near-infrared spectroscopy. With this novel method, we have evaluated tissue oxygenation at the sinusoid level by oxygen saturation of hemoglobin of the red cells, transmembrane transport of indocyanine green by a rate constant of increase phase after indocyanine green administration, and intracellular transport and excretion through bile canaliculi by a rate constant of the decrease phase, respectively. Increase phase after administration was inhibited by bilirubin as a competitive inhibitor of transmembrane uptake of indocyanine green. Decrease phase was inhibited both by colchicine and ouabain via destruction of microtubules in the hepatocyte and suppression of Na-K … More ATPase at bile canaliculi membrane, respectively. Therefore, these two rate constants were certified to be an indicator of transmembrane uptake and intracellular transport and excretion through bile canaliculi of indocyauine green. We applied this method to ischemia reperfusion injury in the liver and showed that transmembrane uptake was injured by ischemia reperfusion injury but recovered rapidly, while deterioration of intracellular transport and excretion through bile canaliculi continued much longer. Since these injuries were related to intracellular decrease of ATP,these injuries were suspected to be caused by deterioration of intracellular Ca metabolism. Furthermore, we used this method for divided liver function tests. We have measured indocyanine green uptake and excretion in the ischemic lobe and control lobe simultaneously. This study showed that non-ischemic lobe was affected by the contralateral ischemic lobe in terms of dye excretion, indicating that ischemic insult should be avoided as less as possible in liver resection. Less