摘要:

AbstractLack of coherence in the results of trace element (TE) analyses produced by various laboratories has been such as to necessitate much needed technical improvements and more detailed control over sample preparations. For too long, except for a few praiseworthy researchers, the importance of sampling conditions has been underestimated as a source of erroneous TE results.Many of the precautionary procedures for previously studied TE collection materials have proven to be so cumbersome that they cannot be applied in a hospital setting. This report deals with sampling material and conditions from a workday standpoint; a rigorous description of the contaminating roles of ambient air and routine handling of specimens places emphasis on the practical. While some metals, including cobalt, copper, iron, and selenium, present no significant risk of contamination, others, such as aluminum, cadmium, chromium, manganese, and nickel, pose quite a significant risk. They warrant attention with respect not only to the sampling itself but also the selection of the material to be used. Drawing on our hospital experience, we propose a critical approach toward the collection of samples of biological fluids (blood, urine, dialysis fluids). Needles, catheters, tubes (open and evacuated systems), and anticoagulants on the market are likewise assessed in terms of their contaminative roles. For each one. elementary rules as well as realistic choices of materials and methods for a hospital environment are proposed.

ISSN:1040-8363    

DOI:10.3109/10408369309084668

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

AbstractCancer cachexia is a complex syndrome characterized primarily by diminished nutrient intake and progressive tissue depletion that is manifest clinically as anorexia and host weight loss. The gradual loss of host protein stores is central to this process. This review outlines the techniques that have been used to evaluate human amino acid metabolism, their application in patients with cancer cachexia, and possible therapeutic interventions designed to overcome alterations in host protein and amino acid metabolism associated with malignant cachexia.The techniques of nitrogen balance and 3-methylhistidine excretion provide indirect estimates of overall nitrogen metabolism and skeletal muscle myofibrillar protein breakdown. Measurement of circulating amino acid concentrations, particularly when combined with assessment of arterial-venous differences and regional amino acid balance allows for investigation of interorgan amino acid metabolism. One of the most significant advances inin vivoamino acid metabolic research has been the development of labeled amino acid tracer studies to evaluate whole body and regional amino acid kinetics. The use of stable and unstable amino acid isotopes in these techniques is reviewed in detail.Virtually all of these techniques have now been employed in the evaluation of human cancer cachexia. The results of studies evaluating amino acid concentrations, regional amino acid balance, and 3-methylhistidine excretion are summarized. The use of regional and whole body kinetic studies in cancer cachexia are reviewed extensively. Most investigators have observed increased rates of whole body protein turnover, synthesis, and catabolism in both weight-stable and weight-losing cancer patients. Some studies have suggested a relationship between the extent of disease and the degree of aberration in amino acid kinetic parameters. Investigators have attempted to reverse some of these alterations by provision of substrate (nutritional support) or administration of specific pharmacologic or anabolic agents such as hydrazine sulfate, insulin, growth hormone, and P-2 agonists. The role of total parenteral nutrition (TPN) in cancer and its effects on protein and amino acid kinetics and tumor growth are addressed. The possible benefits of specific amino acid nutritional formulations with increased branched chain amino acids, arginine, and glutamine are reviewed. Although many of these approaches appear promising, significant impact on clinically definable parameters remains to be demonstrated. A better understanding of the underlying protein catabolic mechanisms of cancer cachexia will likely lead to more effective therapies to reverse the protein calorie malnutrition associated with cancer cachexia.

ISSN:1040-8363    

DOI:10.3109/10408369309084669

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

AbstractPepsinogens, precursors of pepsins (potent and abundant digestive enzymes that are the primary products of the gastric chief cells), are members of the family of aspartic proteases. Because of the heterogeneity of pepsinogens, several classifications have appeared in the literature. I describe the recommended classification and nomenclature of the aspartic proteases and discuss their genetics, biochemistry (structure, activation of zymogens, mechanism of proteolytic activity and inhibitors), and physiology. The focus will be on the zymogens of pepsin, the so-called pepsinogens. The measurement of these enzymes in serum is a reliable noninvasive biochemical method for evaluating peptic secretion and obtaining information on the gastric mucosal status. A detailed review of the methods for the measurement of pepsinogens in serum, urine, and gastric mucosa is also provided. Data on pepsinogen levels in healthy subjects are discussed with respect to sex, age, smoking habit, and the presence of a circadian rhythm.The value of pepsinogen measurements in peptic ulcer to determine ulcer outcome and recurrence, in gastric cancer, and inHelicobacter pyloriinfection is reviewed. Finally, the effects of drugs on peptic secretion are discussed. In light of these data, the measurement of aspartic proteases, and in particular that of pepsinogen A and C, may be regarded as an effective biochemical approach to the evaluation and monitoring of patients with upper gastrointestinal diseases.

ISSN:1040-8363    

DOI:10.3109/10408369309084670

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor