摘要:

Dietary fiber, which stimulates intestinal mucosal growth, is fermented by anaerobic bacteria in the rat hindgut to the short‐chain fatty acids (SCFA) acetate, propionate, and butyrate. Butyrate is the preferred oxidative fuel of the colonocyte in vitro, and the provision of preferred intestinal fuels has been shown to stimulate mucosal proliferation in vivo. This study determined whether chronic colonic infusion of butyrate or a combination of SCFA would stimulate intestinal mucosal growth in an animal deprived of its normal source of SCFA, fiber fermentation in the cecum. Adult male Sprague‐Dawley rats were fed a fat‐ and fiber‐free elemental liquid diet and underwent cecectomy, ileocolic anastomosis, and insertion of a proximal colonic infusion catheter. Rats were then assigned to receive either a continuous infusion of butyrate (20 mM, 40 mM, or 150 mM), SCFA (70 mM acetate + 35 mM propionate + 20 mM butyrate), or saline, or to receive no infusion. A seventh group underwent proximal colonic transection and reanastomosis. After 7 days, jejunal, ileal, and proximal colonic segments were analyzed for mucosal weight, protein, RNA, and DNA. In the colon, the 40‐mM butyrate infusion resulted in significant elevations in all mucosal parameters relative to all three control groups, saline infusion, no infusion, and transection. Both the 20‐mM butyrate and the SCFA groups showed increased colonic mucosal DNA compared to controls. In the jejunum and ileum, mucosal DNA content was significantly greater in the SCFA group than in the control groups. These data indicate that SCFA infused into the rat colon has a trophic effect throughout the intestinal tract, whereas butyrate appears to have its primary trophic effect locally in the colon. (Journal of Parenteral and Enteral Nutrition13:109–116, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002109

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

Diarrhea is one of the most common complications in patients who receive tube‐feeding formulas. Since the colon is the final site of water and electrolyte absorption and ultimately determines fecal composition, diarrhea during tube feeding may result from altered colonic function. The lack of dietary fiber, such as pectin, in tube‐feeding formulas may be one of the means by which colonic function is affected. The purpose of this study was to determine the effect of a standard, liquid, commercially available, isotonic tube‐feeding formula (ITFF) and the effects of supplementing the ITFF with pectin on colonic function as measured by stool consistency and colonic fluid composition in 13 normal adults. Data were obtained when subjects consumed their regular diet, ITFF, and ITFF supplemented with pectin using the technique of in vivo dialysis of colonic fluid. Ingestion of the ITFF resulted in a significant increase in the percentage of liquid stools compared to a regular diet [median (interquartile range) = 0% (0), 60% (64);p<0.01]. Ingestion of the ITFF also resulted in significant decreases in the concentrations of sodium, potassium, and short‐chain fatty acids, and increases in pH and osmotic gap in colonic fluid compared to the subjects' regular diet. Supplementing the ITFF with pectin significantly reduced the incidence of liquid stools [0% (0)]and promoted a normalization of colonic fluid composition. The results suggest that the addition of pectin may enhance tolerance to ITFFs. (Journal of Parenteral and Enteral Nutrition(13:117–123, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002117

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

Patients with alcoholic hepatitis are typically malnourished. A hypermetabolic state would explain, at least in part, the muscle wasting observed in these patients. However, data on hypermetabolism in liver disease are limited and conflicting. In this study, we evaluated measured energy expenditure (MEE)vspredicted energy expenditure (PEE), and MEE in relation to urinary creatinine excretion in 20 patients with moderate and severe alcoholic hepatitis, and 20 controls. Patients with alcoholic hepatitis had depressed creatinine height index (moderate 66%, severe 78%) demonstrating muscle depletion. Patients with alcoholic hepatitis also had depressed mean serum albumin concentrations, the moderate group 2.6 g/dl and the severe group 2.0 g/dl. The mean values for measured energy expenditure in moderate alcoholic hepatitis patients, severe alcoholic hepatitis patients, and the control group were: 1556 kcal, 1878 kcal, and 1943 kcal, respectively. The mean measured energy expenditures per g of creatinine for the same groups were: 1520 kcal, 1813 kcal, and 1043 kcal, respectively. The mean measured energy expenditure/predicted energy expenditure ratio was not increased in alcoholic hepatitis patients compared to controls. However, when related to urinary creatinine excretion, the alcoholic hepatitis patients had a mean measured energy expenditure that was 55% higher than controls. In conclusion, whereas the measured energy expenditure to predicted energy expenditure ratio was not elevated in alcoholic hepatitis patients compared to controls, the measured energy expenditure per gram of creatinine was significantly increased in alcoholic hepatitis patients, supporting the concept of alcoholic hepatitis as a hypermetabolic state. (Journal of Parenteral and Enteral Nutrition13:124–127, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002124

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

The effects of a 60% small‐bowel resection on postoperative visceral organ glucose exchange was studied in order to gain further understanding of the role of the intestinal tract as a supplier of gluconeogenic substrate to the liver following operative stress. We determined the flux of glucose across the gastrointestinal tract, liver, and kidneys in 20 postoperative dogs. With enterectomy portal bloodflow and total hepatic bloodflow were diminished by 33% and 25%, respectively. Arterial glucose was slightly lower in the enterectomized group 6 hr following the operation. Intestinal glucose uptake was diminished by more than 50% in the enterectomized dogs (p<0.01). Net hepatic glucose release fell from 22 μmole/kg/ min to 8 μmole/kg/min (p<0.01). In control animals the kidney was an organ of slight glucose uptake while in the enterectomized group, the kidney released glucose at the rate of 4.1 μmole/kg/min (p<0.05). The data suggest that the gut is an important supplier of gluconeogenic precursors to the liver which are used to support gluconeogenesis in the postoperative period. The ability of the kidney to accelerate glucose production in this setting suggests that metabolic adaptation and cooperation between organs occurs during organ absence or dysfunction which helps preserve glucose homeostasis. (Journal of Parenteral and Enteral Nutrition13:128–131, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002128

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

D‐lactate accumulates in some patients with malabsorption who continue oral intake of carbohydrate leading to a clinical syndrome of acidosis and encephalopathy. To assess the possibility that D‐lactate contributes to acidosis and/ or metabolic bone disease in patients with malabsorption receiving long‐term parenteral nutrition yet maintaining oral intake, D‐lactate levels in serum and urine were measured in 14 long‐term parenteral nutrition subjects (average duration of support 74 months) and 27 control subjects. Significant elevations in both serum and urine D‐lactate were found in only two parenteral nutrition subjects. Both subjects with elevated D‐lactate levels had bone pain, x‐ray evidence of fractures, and biopsy evidence of osteomalacia. These studies suggest that D‐lactate accumulation may be a heretofore unappreciated metabolic abnormality associated with metabolic bone disease and acidosis in patients with malabsorption who are supported by long‐term parenteral nutrition. (Journal of Parenteral and Enteral Nutrition13:132–135, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002132

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

The influence of dietary lipid manipulation on the fever response to an injection of murine recombinant Interleukin‐1 (rIL‐1) in guinea pigs was examined. The animals were fed diets identical except for the lipid source for periods of 5 and 6 wk.In vitrothromboxane B2/B3(TxB2/B3) production in collagen‐stimulated whole blood was also measured. One diet was enriched with menhaden oil, high in the omega‐3 series of fatty acids. The other diet contained safflower oil, consisting primarily of the omega‐6 fatty acid linoleic acid (74%). Animals fed the fish oil‐enriched diet for 6 wk not 5 week had a blunted fever response after rIL‐1 injection. This was associated with a 27% increase (p<0.05) in total omega‐3 fatty acids in plasma phospholipids between weeks 5 and 6 in fish oil‐fed animals. Safflower oil‐fed animals produced a “normal” febrile response regardless of the duration of feeding. Safflower‐fed guinea pigs demonstrated a significant increase in TxB2/B3production in whole blood after 6 wks that was associated with a 25% increase (p<0.05) in plasma phospholipid arachidonic acid levels between weeks 5 and 6. Despite significant reductions in phospholipid linoleic acid in animals fed fish oil, arachidonic acid levels remained unchanged.In the guinea pig model used, long‐term menhaden oil feeding can significantly blunt the febrile response induced by exogenous Interleukin‐1. Also, a high intake of linoleic acid as seen in safflower oil feeding can significantly increase thromboxane production in stimulated whole blood. Thus, the type of fatty acids available at the substrate level could affect the physiologic response to injury and/or infection. (Journal of Parenteral and Enteral Nutrition13:136–140, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002136

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

Metabolic and respiratory interactions were analyzed in a large group of septic patients (S) and in a reference group of nonseptics (NS) during the iv administration of glucose and fat. In spite of a moderate increase in CO2production (VCO2) observed during the administration of fat in S, a VCO2‐sparing effect of fat, with respect to equicaloric amounts of glucose, was reconfirmed. The relevance of the therapeutic modulation of CO2production during parenteral nutrition, and the relative impact on the abnormal septic respiratory patterns, were emphasized by analyzing the physiological relationships and mechanisms responsible for the increase in respiratory work in sepsis. (Journal of Parenteral and Enteral Nutrition13:141–146, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002141

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

Systemic scleroderma often involves the gastrointestinal tract and can lead to significant malnutrition. Specialized home nutritional support was provided to five patients (one enteral and four parenteral) with restoration of adequate nutritional status, improved quality of life, and few metabolic or technical complications over a period of 12 to 86 months. Three patients eventually died of their disease, one was converted to an oral diet, and one patient remains dependent on total parenteral nutrition. This experience would recommend consideration of home nutritional support in patients with systemic scleroderma when the disease is relatively stable and no major organ failure is present. (Journal of Parenteral and Enteral Nutrition13:147–151, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002147

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

We examined the effect of nutritional supplementation for 13 wk on anthropometric, pulmonary function, and immunological status in malnourished ambulant patients with pulmonary emphysema (EP). The study was placebo controlled, randomized and double blind. Twenty‐eight patients were included. Thirteen patients in the fed group were provided with a nutritional formula providing 20% protein, 30% fat, and 50% carbohydrate, 1 Kcal/ml, 400 ml/day. The control group was provided with a reference product of the same consistency and taste containing 0.1 Kcal/ml, 400 ml/day for 13 wk. The fed group had a mean weight gain of 1.5 kg during the study period, the control group increased concomitantly 0.16 kg, the difference being significant (p<0.01). Sum of four skinfolds increased 2.7 mm in the fed group, and decreased 0.9 mm in the control group the difference being significant (p<0.01). No difference were observed regarding pulmonary function or immunological status. We also found a high habitual energy intake in our study group (204% Basal Energy Expenditure). We conclude that nutritional supplementation produce weight gain in malnourished patients with EP, but it does not change other indices of well‐being. (Journal of Parenteral and Enteral Nutrition13:152–156, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013002152

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718901300210

出版商:SAGE Publications    

年代:1989

数据来源: WILEY