摘要:

Following either standardized stapled resection of an ileal blind loop terminus (17 beagles) or construction of a colorectal anastomosis (10 beagles), half the subjects immediately were fed an elemental diet (Vivonex HN). Gastrointestinal (GI) motility and absorption were maintained by exclusion of swallowed air. Controls received the same rate of feeding solution containing only the electrolyte components. Four days postoperatively, the fed beagle's colorectal anastomosis had over double the bursting pressure of the control, 303 ± 36 versus 138 ± 46 mm Hg (p>0.001). At this time, the mature collagen content of the fed subjects' ileal wound was undiminished from that of normal ileum, 2,223 ± 336 verus 2,250 ± 577, contrasting with the 45% decrease of this structural component (OHP) in the wounds of the unfed controls, 1,237 ± 820 μg/g of tissue (p>0.001). Similarly, the wounds of fed but not unfed subjects had a doubling (p>0.001) in concentration of collagen precursors and “new” collagen. The “catabolic” and “lag” phases, as noted in unfed experimental animals, appeared to be reflections of the relative starvation that accompanied the intestinal wounding. With maintenance of GI function and immediate full enteral nutrition, “accelerated healing” was noted relative to the previously considered “norm.”

ISSN:0148-6071    

DOI:10.1177/0148607180004006535

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

摘要:

Nutritional effects of intravenous infusion of an amino acid (AA) mixture enriched with the branched chain AA were previously evaluated at a daily level of 45 kcal and 200 mg N using male rats weighing approximately 200 g. The present study was conducted with male rats weighing approximately 200 g to evaluate the nutritional effects of 1) an AA infusion solution at further increased energy level, and 2) an AA solution devoid of aspartic and glutamic acids. By increasing daily energy input from 45 to 55 kcal/rat, the body weight gain of rats was markedly increased and more positive nitrogen balance was observed. Glucose, albumin, and free AA levels were unchanged in plasma of rats after the infusion period, while plasma urea level was somewhat lowered. Organ weights and liver lipid content were also unchanged. The administration of an infusion solution devoid of aspartic and glutamic acids resulted in little alteration in the amounts of urinary excretion and plasma levels of these acidic AA. Furthermore, other parameters measured showed no significant effect of the deletion of the AA. These results indicate that no advantage is expected in the use of acidic AA for parenteral nutrition.

ISSN:0148-6071    

DOI:10.1177/0148607180004006539

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

摘要:

Rats and chickens, unlike man, utilize D‐methionine efficiently. We have studied urinary excretion of methionine isomers in young miniature pigs, adult rabbits, and adult dogs given D‐methionine in an attempt to find an animal model that, like man, utilizes the D‐isomer poorly. Six‐week‐old miniature pigs ingesting a protein‐free diet were infused with 8.5% amino acid solutions differing only in methionine isomer content (L‐ VS DL‐) to supply amino acid requirements. Each solution was infused for a 2‐ or 3‐day period in a cross‐over design. Plasma methionine levels were significantly higher (p = 0.01) during infusion of the solution providing DL‐methionine, with 25% of total plasma methionine present as the D‐configuration. However, urinary methionine excretion was similar with both solutions, with D‐methionine utilization calculated as greater than 99%. Adult rabbits ingesting DL‐methionine (0.14 g/100 g food) showed good utilization of D‐methionine, excreting>1.3% D‐isomer in the urine. Mixed breed dogs given 1.25 g D‐methionine in their drinking water excreted>0.4% of ingested D‐methionine in the urine. These data indicate that the pig, rabbit, and dog utilize D‐methionine efficiently, behaving like the rat and chicken rather than man.

ISSN:0148-6071    

DOI:10.1177/0148607180004006544

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

摘要:

Previous studies have shown that amino acid (AA) residues are absorbed more rapidly from di‐ and tripeptides than from free AA. In the present study, an intestinal perfusion technique has been used in normal human subjects to compare absorption of AA residues and total α‐amino nitrogen (N) from 4 partial enzymic hydrolysates of protein (50–80% of the N contents present as small peptides) and their respective equimolar free AA mixtures. α‐Amino N absorption was greater from 2 casein hydrolytes and a lactalbumin hydrolysate than from the respective free AA mixtures but similar to that from a fish protein hydrolysate and its AA mixture. The considerable variation in absorption of individual AA residues from the AA mixtures was much reduced when the protein hydrolysates were perfused, as a number of AA which were poorly absorbed from the AA mixtures were absorbed to a greater extent from the protein hydrolysates. The casein and lactalbumin hydrolysates had a stimulatory effect on jejunal absorption of water and electrolytes. In contrast, the fish protein hydrolysate appeared to cause a mean net secretion of fluid and electrolytes. The findings indicate that when absorption is limited by diminished luminal hydrolysis or absorptive capacity, serious consideration might be given to using partial enzymic hydrolysates of whole protein rather than free AA mixtures as the N source in “elemental” diets. Care should be taken, however, in ensuring that the preparation of choice does not promote a net secretion of fluid and electrolytes for such a property could have a deleterious effect in the clinical setting.

ISSN:0148-6071    

DOI:10.1177/0148607180004006548

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

摘要:

Ten patients (24–66 yr), maintained on ambulatory home intravenous hyperalimentation (HIVH) for 3 years, have undergone psychological evaluation. Acceptance of oral deprivation and the inconveniences, restraints, and risks of long‐term or life‐long HIVH, and the mechanisms for coping with these stresses, varied among this group. At times, the fear related to the HIVH apparatus and its function assumed almost delusional proportions; at other times, the patients acted indifferently or even irresponsibly toward the management of their life‐sustaining system. These patients had to cope with public inquisitiveness as well as their own self‐consciousness in public. Stress seemed to be related to the patient's prognosis, not only regarding recovery from the primary pathologic process, but also his/her prospects for return of normal gastrointestinal function. Stress reactions also varied among the spouses and families of the patients, and the quality of their psychological, support appeared to affect the patient's mental, physical, and social wellbeing significantly. An entirely new spectrum of psychologic and social problems have emerged to challenge the IVH team who successfully manage patients unable to sustain themselves nutritionally. It is imperative that we recognize, prevent, ameliorate, and treat these problems with the same degree of enthusiasm and competence with which we nourish the patients.

ISSN:0148-6071    

DOI:10.1177/0148607180004006554

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

摘要:

Literature concerning zinc and/or copper investigations pertaining to cancer is surveyed; the interrelationships of zinc, copper, and parenteral nutrition (PN) in cancer are examined; and the advantages of adequate nutritional support for patients with malignancies are discussed. Zinc and copper are both essential trace elements and, therefore, are necessary nutrients for cancer patients. Zinc supports growth, including that of neoplasia; copper is a zinc competitor and antagonist; and cancer patients on PN are in danger of becoming both zinc‐and copper‐deficient. The addition of these trace elements as supplements to PN formulae is undertaken with knowledge of only the approximate concentrations of zinc and copper in total intake, but without knowledge of specific requirements for cancer patients for these trace elements, of all the possible interactions of zinc and copper with each other or different trace elements, or even of zinc and copper lower levels of toxicity in cancer patients; balance studies are needed to determine zinc and copper requirements in them. In the future, it is conceivable that manipulations of the host nutrients might be used to control tumors. This might be accomplished by adjusting total PN formulae so that required nutrients will be presented to a cancer patient in such amounts and in such ratios that a desired alteration may be effected in that patient's metabolism.

ISSN:0148-6071    

DOI:10.1177/0148607180004006561

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

摘要:

Plasma free fatty acid (FFA) turnover and oxidation were determined by the primed continuous infusion of albumin bound (1‐14C) palmitic acid in 2 patients after an overnight fast and during fat‐free total parenteral nutrition (TPN), in 1 during fat‐free TPN, and in another in whom one‐third of calories were administered by the continuous infusion of Intralipid via a central venous catheter in conjunction with a standard glucose‐amino acid solution. During TPN, plasma FFA concentrations in 2 patients were reduced from 0.7 to 0.11 and 0.08 mM, respectively, and their plasma FFA turnover during TPN was only 26% (3.86 and 2.68 μmol/min/kg) of that prior to TPN. In these subjects prior to TPN, 33 and 47% of the plasma FFA turnover was immediately oxidized, accounting for 58% of the CO2output; however, during TPN only 16% of the plasma FFA turnover was oxidized, accounting for 10% of the caloric expenditure. The plasma FFA kinetics in the third patient were similar to those described for the first two. In contrast, the plasma FFA concentration of the fourth patient during Intralipid TPN was 0.4 mM. His plasma FFA production was 11.3 μmol/min/kg, of which 18.4% was immediately oxidized, contributing 28% to the total CO2output. These studies indicated that during fat‐free TPN plasma FFA turnover is reduced and plasma FFA oxidation is a minor contributor to energy homeostasis; however, when one‐third of the calories are supplied by fat emulsion, plasma FFA turnover is appreciable and the oxidation of plasma FFA is an important source of energy.

ISSN:0148-6071    

DOI:10.1177/0148607180004006572

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1002/j.1941-2444.1980.tb04850.x

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1002/j.1941-2444.1980.tb04851.x

出版商:SAGE Publications    

年代:1980

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1002/j.1941-2444.1980.tb04852.x

出版商:SAGE Publications    

年代:1980

数据来源: WILEY