title: Noninvasive evaluation of cytochrome c oxidase activity of the liver. Its prognostic value for hepatic resection.
abstract: OBJECTIVE
  To clarify the relationship between the noninvasive evaluation of hepatic mitochondrial function, the redox tolerance test, and cytochrome c oxidase activity of the liver, focusing on surgical risk in hepatic resection.
  
  
  METHODS
  Six-month randomized clinical trial.
  
  
  METHODS
  Inpatients in surgical department.
  
  
  METHODS
  Forty patients who underwent hepatic resection (n = 36) and other abdominal operations (n = 4).
  
  
  METHODS
  Preoperative, noninvasive: The redox tolerance test, which measures the changes in arterial ketone body ratio in response to 75 g of oral glucose loading. Intraoperative, invasive: Cytochrome c oxidase activity and energy charge of the liver.
  
  
  METHODS
  Correlation of the index in the redox tolerance test (RTI) with cytochrome c oxidase activity, both of which predict the postoperative course.
  
  
  RESULTS
  The RTI values were negatively correlated with the maximal velocity (Vmax) and Michaelis constant (Km) values of cytochrome c oxidase activity. The maximal velocity and Michaelis constant values in patients with RTI values above or equal to 0.5 (group A, n = 29) were significantly lower than those in patients with RTI values below 0.5 (group B, n = 11). Eight (72.7%) of 11 patients in group B experienced postoperative complications.
  
  
  CONCLUSIONS
  The RTI is a noninvasive method of assessing the hepatic energy metabolism and can be a useful index for evaluating surgical risk in hepatectomy.
authors.affiliation: Second Department of Surgery, Kyoto University Faculty of Medicine, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Ueda
authors.forename: K
authors.initials: K
authors.lastname: Mori
authors.forename: Y
authors.initials: Y
authors.lastname: Sakai
authors.forename: A
authors.initials: A
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Katayama
authors.forename: A
authors.initials: A
authors.lastname: Maki
authors.forename: Y
authors.initials: Y
authors.lastname: Shimahara
authors.forename: Y
authors.initials: Y
authors.lastname: Yamaoka
authors.forename: K
authors.initials: K
authors.lastname: Ozawa
mesh_terms: D000227:Adenine Nucleotides / Q000378:metabolism; D000328:Adult; D000368:Aged; D003576:Electron Transport Complex IV / Q000378:metabolism*; D005069:Evaluation Studies as Topic; D005260:Female; D005951:Glucose Tolerance Test; D006498:Hepatectomy; D006801:Humans; D007657:Ketone Bodies / Q000097:blood; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D008930:Mitochondria, Liver / Q000201:enzymology; D010084:Oxidation-Reduction; D011379:Prognosis
chemical_list: D000227:Adenine Nucleotides; D007657:Ketone Bodies; D003576:Electron Transport Complex IV