摘要:

Plasma concentrations of 25 essential (EAA) and nonessential (NEAA) amino acids were measured pre‐ and postdialysis in 46 chronic hemodialysis therapy (CDT) patients. Sixteen of these patients with prior weight loss of 14.5 ± 2.37 pounds in 24 months were administered a GAA solution (EAA + NEAA + glucose) for 20 weeks during each dialysis. Eight of these patients (group 1) responded with improved appetite and weight gain; the remaining eight patients (group 2) with clinically advanced metabolic bone disease continued to lose weight. Five other patients (group 14), biochemically similar to group 1 but with shorter prior dialysis experience, who received EAA (plus glucose) hyperalimentation (including oral L‐histidine), experienced weight gain similar to group 1 but displayed significantly different plasma aminograms indicating a deficit of NEAA. When EAA and glucose hyperalimentation was administered without histidine (1 patient) no weight gain occurred and aminograms differed significantly from other groups. Plasma aminograms of 25 weight‐stable, nonhyperalimented CDT patients were obtained for comparison. Results indicate GAA hyperalimentation can promote weight gain in catabolic CDT patients with inadequate prior nutritional intake (as in groups 1 and 14) but cannot reverse weight loss when the primary clinical setting is advanced metabolic bone disease and myopathy due to hyperparathyroidism (group 2). Hyperalimentation with glucose and an amino acid solution specifically tailored to the needs of CDT patients may improve results. Plasma phosphoethanolamine levels, normal for weight‐stable and elevated in catabolic CDT patients, suggest a possible role for phosphoethanolamine as a marker for catabolism.

ISSN:0148-6071    

DOI:10.1177/0148607181005006463

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

The gastrointestinal response to oral alimentation of low residue commercial defined formula diets or a rat liquid formula was studied. Male Sprague‐Dawley rats (220–250 g) were fed isocaloric amounts (73 kcal/day) of Vivonex (V), Vivonex HN (VHN), Flexical (F), Vital (Vit), or a control Casein diet 116EC (C). Nitrogen (N) retention was calculated from N intake minus N excretion/day. After 2 weeks, rats were killed and the liver, pancreas, and small bowel removed and weighed. Pancreatic amylase activity (U g) and liver lipid were measured. The bowel was divided into eight equal segments, and mucosal weight, DNA, and protein concentration per centimeter were measured. Despite isocaloric feeding, body weight gain was lower in V and VHN groups, and higher in F and Vit groups compared to the C. Amylase specific activity was increased in V, VHN, and F groups, while the liver lipid was increased in the V and VHN groups when compared to C animals. The most proximal intestinal segment weight, mucosal weight, protein and DNA of V, VHN, and Vit groups were less than C animals, while distal segments were similar. F animals showed greater intestinal mass than C rats. These studies indicate statistically significant differences in gastrointestinal responses as a result of nutrient variation of defined formula diets.

ISSN:0148-6071    

DOI:10.1177/0148607181005006478

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Available data indicate little reutilization of 3‐methylhistidine (3‐MH) in the rat and man. These data led to the use of urinary 3‐MH excretion as a measure of muscle protein catabolism in those animal species. However, 3‐MH excretion does not accurately measure protein catabolism in the sheep, pig, and rabbit. This is due, at least in part, to the fact that renal amino acid (AA) transport systems reabsorb 3‐MH from the glomerular filtrate. The monkey differs from man in that its plasms contains significant quantities of 3‐MH, suggesting an active renal transport system for this AA. The present study measured maternal and fetal plasma 3‐MH levels in 33 pregnant rhesus monkeys to determine whether the nonhuman primate placenta contained transport sites concentrating this AA to the fetal plasma. Mean fetal plasma 3‐MH concentrations were 16.4 ± 6.71 μmol/100 ml, while maternal levels were 9.45 ± 3.69 μmol/100 ml. The fetal to maternal gradient was maintained between 1.6 to 1.7 during the course of maternal infusions of various AA. Since placental AA transport systems are similar to those in the kidney and intestine, the data also suggest the presence of AA transport systems for 3‐MH in the monkey, indicating that urinary 3‐MH excretion would be a poor method for measuring muscle protein catabolism in this species.

ISSN:0148-6071    

DOI:10.1177/0148607181005006485

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

The potential of nutritional assessment parameters in predicting sepsis in burn patients was investigated. Sixty‐two consecutive patients (mean age 41 years) with an average burn size of 19% were studied. Values were obtained on postburn day 10 for serum albumin, transferrin, nitrogen balance. total lymphocyte count, skin test reactivity. and nercentage of ideal body weight. Parameters predictive of an imminent septic episode included serum albumin<3.0 g/dl (p<0.001), total lymphocyte count<1500/MM3 (p<0.001), anergy (p<0.001), and serum transferrin<150 mg/dl (p<0.01). Nitrogen balance and percentage of ideal body weight were not found to contribute to group discrimination.

ISSN:0148-6071    

DOI:10.1177/0148607181005006488

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

The effect of 6‐day dietary arginine supplementation on the weight gain, blood glucose, thymus weight, thymic lymphocyte content, and in vitro thymic lymphocyte immune‐reactivity was studied in obese (C57BL/6J‐OB/OB) and heterozygous lean mice. Control mice were fed a commercial laboratory chow (1.8% arginine content) and drank tap water, while supplemented mice were given 0.5% arginine in the chow and 0.5% arginine solution for drinking. All mice ate and drank ad libitum. Supplemental arginine significantly decreased the weight gain (1.2 g vs. 2.2 g, p<0.01) and blood glucose levels (303 mg% vs 236 mg%, p<0.02) of the OB/OB mice; no such effects were noted in the lean heterozygotes, all of which had normal blood glucose levels. OB/OB mice had thymus glands which weighed less and contained significantly fewer lymphocytes than their lean littermates. In vitro mitogen‐stimulated thymic lymphocyte protein synthetic rates were equal in chow‐fed lean and OB/OB mice. In both groups, supplemental arginine significantly increased thymus weight, the number of thymic lymphocytes per gland, and thymic lymphocyte immunereactivity in vitro. The hormonal secretagogue activity of arginine on the pituitary may explain its beneficial effects on the rate of weight gain, hyperglycemia, and depressed thymic immune function of OB/OB mice.

ISSN:0148-6071    

DOI:10.1177/0148607181005006492

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Previous reports regarding the effect of an elemental diet (ED) on pancreatic secretion have been conflicting. This study was designed to assess the effect of a high‐nitrogen ED or total parenteral nutrition (TPN) on proteolytic activity in the pancreatic exocrine cell. Forty‐eight dogs were divided into 12 groups of 4 each. Group I (control) was fed commercial dog food. Groups II, III, and IV received 1, 2, and 3 days, respectively, of 25% glucose with 4.25% amino acids. Groups V, VI, and VII received 1, 2, and 3 days, respectively, of 25% glucose with 2.75% amino acids. Groups VIII, IX, and X received 3 days of ED given orally, via gastrostomy or jejunostomy, respectively. Groups XI and XII received 1 day each of either 2.75% amino acids or 25% glucose. The pancreas of each dog was then resected and processed for electron microscopy, or minced and analyzed for tryptic activity expressed as micro‐moles of benzoyl arginine ethyl ester (BAEE) digested per milligram of pancreatic protein. There were no significant differences in ultrastructure or in the levels of pancreatic tryptic activity between the control and the 11 experimental groups. It appears that during the short period of our treatment with TPN as well as with ED, the exocrine cell retains its normal content of proteolytic enzyme. Reports of others that pancreatic secretion volume decreases with TPN and ED, coupled with our findings of stable intracellular tryptic activity, indicate that the synthesis and release of proteolytic enzymes have actually been reduced by TPN and ED. Thus, TPN or ED should benefit the patient with pancreatitis by decreasing pancreatic secretion as well as pancreatic proteolytic enzyme synthesis.

ISSN:0148-6071    

DOI:10.1177/0148607181005006496

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

A combination of pancreatic insufficiency and inadequate caloric intake may produce essential fatty acid (EFA) deficiency in patients with cystic fibrosis. Seventy‐five percent of the adolescents and young adults with poor weight gain in our clinic were EFA‐deficient by total plasma linoleic acid criteria. Twenty of these patients were placed on an oral hyperalimentation regimen containing 230% of calories required for basal energy expenditure, 40% as fat. Forty percent of these (8/20) achieved normal EFA levels on this diet. Eight of the nonresponding patients were given an additional 5% of their caloric intake as linoleic acid monoglyceride. All who maintained caloric intake achieved normal EFA levels. Normalization of EFA levels was associated with a number of clinical benefits including increase in weight and activity and, in five teenage girls, regulation of menses. The 16 control patients who received standard pancrelipase therapy and nutritional supplements remained fatty acid deficient. We conclude that oral hyperalimentation can restore EFA levels in cystic fibrosis patients if adequate calories are available to provide energy needs.

ISSN:0148-6071    

DOI:10.1177/0148607181005006501

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Urinary free and total carnitine excretions were measured in 41 normal adults and seven surgical patients on fat‐free total parenteral nutrition for 8 to 45 days. The means (±SEM) of urinary free and total carnitine excretions in normal adults were 162 ± 19 and 328 ± 28 μmol/days, respectively. All of the patients exhibited protein‐calorie malnutrition with a mean carnitine intake of 11.6 ± 1.5 μmol/day. Under this stringent carnitine economy with the adequate supply of lysine and methionine, urinary total carnitine excretion significantly reduced to 127 to 162 μmol/day. This probably reflects the carnitine biosynthetic rate. However, during the periods of operation and/or infection, urinary total carnitine excretion significantly increased 2‐ to 7‐fold that of normal levels. Significant positive correlation was found between the two forms of urinary carnitine and total nitrogen excretions. Serum free and total carnitine levels in patients were significantly higher than normal adults. Such findings can be explained by the endocrine responses to the stress phenomenon and indicate a catabolic response of skeletal muscle in which most of the body carnitine resides. This can impair their carnitine status.

ISSN:0148-6071    

DOI:10.1177/0148607181005006505

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

To study the effects of intravenous doxycycline hyclate on protein malnourished rats, 20 male Sprague‐Dawley rats, weighing 234 to 277 g, were protein depleted for 6 weeks then randomly assigned to one of two groups: group I (10 rats), total parenteral nutrition with intravenous doxycycline hyclate injections, group II (10 rats), total parenteral nutrition with normal saline injections. Both groups were then protein repleted for 7 days. Body weight; fluid intake; urine output; liver, spleen, and lung weights; nitrogen content; and serum proteins were measured. The antibiotic dosage given was 10 mg/kg body weight/day or 0.1688 ± 0.0046 mg/day. There was no significant difference in starting weight, weight after 6 weeks of protein depletion, weight at sacrifice, or weight gain between groups I and II. Average fluid intake/day for groups I (50 ± 2 ml) and II (51 ± 3 ml) were not statistically significant. There was no significant difference in average urine output/day nitrogen balance, liver weight, and liver nitrogen, spleen and lung weights, or serum albumin levels (Group I, 2.84 ± 0.48 g%, Group II, 2.72 ± 0.24 g%). Intravenous doxycycline hyclate does not appear to have a protein catabolic effect on protein malnourished rats receiving total parenteral nutrition.

ISSN:0148-6071    

DOI:10.1177/0148607181005006510

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

This report documents a specific situation in which indirect calorimetry produced large overestimations of oxygen consumption and energy expenditure of a patient on a respirator. High positive‐end expiratory pressures combined with high fractional concentrations of O2 led to perforation of lung parenchyma with considerable loss of O2, which produced subcutaneous emphysema and recurrent pneumothoraces. Typical calculations for determining energy expenditure from O2 consumption, therefore, could not be employed. Calculations utilizing the volume of CO2expired, however, were less sensitive and variable during this time period. Resting energy expenditures were calculated from the volume of CO2expired by using 5.52 kcal/1 as the caloric equivalent of CO2. This procedure does not overestimate energy needs when a physiological gas leak exists (high positive‐end expiratory pressures and high fractional concentrations of O2 or chest tube). This is very important in the ventilatory patient as excess carbohydrate can further stress the compromised pulmonary status.

ISSN:0148-6071    

DOI:10.1177/0148607181005006513

出版商:SAGE Publications    

年代:1981

数据来源: WILEY