摘要:

Short‐chain fatty acids (SCFA), fermentation products of fiber, are believed to play a role in intestinal adaptation. Although the administration of fiber or the infusion of SCFA has been shown to cause colonic growth, studies have been done primarily in enterally fed animals. In addition, the effects of SCFA on absorptive function have not been determined. Adult male rats were maintained on total parenteral nutrition (TPN) and, in addition, received either 150 mmol/L of saline or 150 mmol/L of SCFA mixture (60:25:15, acetate:propionate:butyrate) into the proximal colon. One week later, the invivoabsorption of water, electrolytes, and 20 mmol/ L of butyrate was measured. After the rats were killed, parameters of colonic mass were determined. SCFA infusion into the colon had no significant effect on absorptive function. However, significantly greater mucosal height (p<.01) and mucosal DNA (p<.05), were observed. Although SCFA has a modest effect on colonic structure, they do not influence absorptive function in TPN rats. (Journal of Parenteral and EnteralNutrition16:1–4, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600101

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

摘要:

This study investigates the effects of gross loss of body weight on glucose disposal (GD), storage (GS), oxidation (GO), and the thermogenic response (TR) during hyperinsulinemic euglycemic glucose infusion in 9 underweight but nourished patients (UP) and in 3 of the patients after weight gain (WGP). In UP, baseline metabolic rate (MR) was 4.1 ± 0.2 kJ/min and respiratory exchange ratio (RER) 0.97 ± 0.02. During the final 30 minutes of hyperinsulinemia MR rose by 0.32 ± 0.07 kJ/min (p<.01) and RER rose to 1.09 ± 0.03 (p<.01). GD was 61 ± 3 μmol/kg per minute, GO 35 ± 1 μmol/ kg per minute, and GS 26 ± 4 μmol/kg per minute. The energy cost of glucose storage as glycogen was 0.15 kJ/min, and as lipid was 0.2 kJ/min. In WGP baseline MR was 4.5 ± 0.4 kJ/ min and RER was 0.91 ± 0.03. During hyperinsulinemia MR rose by 0.63 ± 0.2 kJ/min, RER rose to 0.93 ± 0.02, GD was 53 ± 4 μmol/kg per minute, GO was 30 ± 3 μmol/kg per minute, and GS was 23 ± 1 μmol/kg per minute. The energy cost for this glucose storage was 0.22 kJ/min.Therefore, during hyperinsulinemia in UP, GD, and TR are similar, but GO is greater and GS is less than previously reported in healthy subjects. However, this TR is entirely accounted for by the energy cost of glucose storage with no evidence of facultative thermogenesis. In WGP, all responses were similar to those in healthy subjects, and the TR was in excess of that required of the energy cost of glucose storage. (Journal of Parenteral and Enteral Nutrition16:5–10, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600105

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

摘要:

The metabolic response to complete spinal cord injury was prospectively studied in 10 patients with Frankel class A spinal cord injury. Weekly excretory and balance studies profile the changes in nitrogen, calcium, and 3‐methylhistidine excretion in relation to body weight and metabolic rate. The initial resting energy expenditures were 10% below what was predicted, and body weight decreased by 10%. Nitrogen excretion paralleled the changes in body weight. Calcium excretion increased for 3 weeks and reached a plateau 150% above baseline. Our results chronicle the magnitude of metabolic response to spinal shock. Comparison with reported values shows this response exceeds that seen in immobilized patients. Nitrogen excretion rose to levels seen in highly stressed patients and must be considered in the management of patients with acute spinal‐cord injury.(Journal of Parenteral and Enteral Nutrition16:11–15, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600111

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

摘要:

During total parenteral nutrition (TPN) gallbladder bile stasis and hypomotility have been well documented. Little is known, however, about the effect of the separate components of TPN on gallbladder motor function. Inasmuch as fat, administered intraduodenally, is a potent stimulus of cholecystokinin (CCK) secretion and gallbladder contraction we have investigated whether intravenous (IV) fat affects gallbladder motility. Six healthy volunteers were studied on two separate occasions, during infusion of Intralipid 10%, 200 mL/h or saline infusion (control) for 3 hours, to evaluate the effect of IV infusion of fat on (1) plasma CCK concentration and gallbladder volume and (2) CCK‐induced gallbladder emptying. Intravenous infusion of Intralipid resulted in significant increases in serum triglycerides from 0.9 ± 0.1 to 5.1 ± 1.3 mmol/L (at 90 min). During fat infusion no significant changes in plasma CCK and gallbladder volume were noted when compared with basal values or to the control experiment. During IV fat, concomitant infusion of 0.25, 0.5, and 1.0 Ivy dog unit (IDU) per kilogram per hour of CCK‐33 resulted in a significant reduction in gallbladder volume from 26 ± 6 cm3(basal) to 15 ±4cm3(p<.05),6±2cm3(p<.05) and 2.5±1cm3(p<.05), respectively. No significant differences in CCK‐induced gallbladder emptying were observed between IV fat and saline infusion (control). It is concluded that, in contrast to intraduodenal fat, IV infusion of fat does not affect (1) basal plasma CCK and gallbladder volume and (2) CCK‐induced gallbladder contraction. (Journal of Parenteral and Enteral Nutrition16:16–19, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600116

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/0148607192016001011

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

摘要:

Dipeptides have been reported to be more efficiently absorbed from the gastrointestinal tract than free amino acids. The objective of this study was to compare prospectively a peptide enteral formula (PEF) with a standard enteral formula (SEF) for tolerance and nutritional outcome in acutely injured, hypoalbuminemic (<3.0 g/dL) patients who require enteral nutrition support. The prevalence of diarrhea and elevated gastric residuals was assessed daily. Prealbumin, transferrin, colloid oncotic pressure, Prognostic Nutritional Index, and nitrogen balance were measured on days 0, 5, and 10 of enteral nutrition support.Forty‐one patients received 345 days of enteral nutrition support. Prevalences of diarrhea and elevated gastric residuals were similar between groups. Prealbumin increased and the Prognostic Nutritional Index decreased significantly from baseline at day 10 in both groups. Transferrin increased in both groups, but not significantly. Colloid oncotic pressure increased significantly from baseline at days 5 and 10 in the SEF group and day 10 in the PEF group. Nitrogen balance increased significantly from baseline at days 5 and 10 in each group. The only significant difference between groups was for nitrogen balance at day 10, which was higher in the SEF group. We conclude based upon our selected measurements of tolerance and nutritional outcome PEF seams to offer no advantage over SEF in acutely injured, hypoalbuminemic patients. (Journal of Parenteral and Enteral Nutrition16:20–24, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600120

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

摘要:

Because protein‐malnourished or endotoxemic patients are at an increased risk of developing nosocomial infections, this study was performed to investigate the effects of protein malnutrition and endotoxemia, alone and in combination, on systemic and intestinal immunity. Protein malnutrition was created by feeding the animals a solid diet containing 0.03% protein. Subgroups of these protein‐malnourished mice were killed after being challenged with saline or endotoxin on days 0, 7, 14, or 21. At death, the animals were weighed, tissues were harvested for histologic analysis (ileum, mesenteric lymph node [MLN], liver, and spleen), mitogen responsiveness (MLN, Peyer's patches, and spleen), and xanthine oxidase measurements (ileum and cecum). Separate groups were evaluated for survival. Both the saline and endotoxin‐challenged mice had lost about 30% of their body weight after 21 days on the low‐protein diet. The protein‐malnourished mice were more susceptible to endotoxin‐induced mortality (70% at 21 days) than the normally nourished mice (0%) (p<.001). The mitogen responsiveness of the protein‐malnourished mice to the T‐cell mitogens (PHA and Con‐A) progressively decreased the longer the mice were protein malnourished, and this decrease in blastogenic responsiveness was associated with histologic evidence of lymphoid atrophy. In contrast, the blastogenic response to the primarily B‐cell mitogen, PWM, was largely preserved. The endotoxin challenge further depressed the immune state of mice tested after 0, 7, or 14 (but not 21) days of protein malnutrition. Thus, both protein malnutrition and endotoxin impaired systemic and gut‐associated immune responsiveness to mitogens. However, in the protein‐malnourished. mice, the degree of immune suppression did not correlate with endotoxin‐induced mortality. (Journal of Parenteral and Enteral Nutrition16:25–31, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600125

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

摘要:

Sebacic acid (C10), a saturated, straight‐chain dicarboxylic acid with 10 carbon atoms in disodic salt form, was given intravenously to two groups of healthy male volunteers in order to evaluate its possible use in total parenteral nutrition. The first group, composed of six subjects, received 1000 mg of sebacate as a bolus; six other subjects (second group) received 10 g of sebacate dissolved in 500 mL of double‐distilled water at an infusion rate of 3.33 g/h over 3 hours. The serum sebacate data for each subject were analyzed by computer, using biexponential fit corresponding to a 2‐compartment open model. The distribution half‐life (t½) was 0.34 ± 0.06 hour and the elimination phase was rather rapid (Ke = 2.10 ± 0.38/h); the volume of the central compartment was 2.79 ± 0.54 L and the volume of tissue compartment 3.72 ± 0.14 L. These data showed a good tissue fixation of sebacate. The plasma clearance was evaluated to be 5.96 ± 2.19 L/h and the renal clearance was 19.22 ± 10.69 L/h, indicating that a tubular secretion of C10 takes place. The serum concentration of sebacate raised to the maximal value at the end of the infusion (180 minutes), corresponded to 480.50 ± 43.02 μg/mL. Respiratory and metabolic parameters were evaluated by indirect calorimetry from the beginning of the infusion for 210 minutes. The O2consumption (VO2mL/min per square meter) remained essentially unchanged throughout the experiment (from 154.3 ± 28.3 at time 0 to 155.3 ± 39.5 at time 180 minutes). The CO2production (VCO2mL/min per square meter) decreased from below basal values (147.7 ± 27.3) to 123.7 ± 25.0 at the end of the infusion. Thus, respiratory quotient (RQ) decreased significantly (from 0.96 ± 0.04 to 0.81 ± 0.06) and the percentage of calories derived from lipids increased during and after the infusion (from ‐0.13 ± 13.3 to 52.1 ± 26.2). Metabolic rate (MR, kcal/h per square meter) remained constant during the entire study period. In conclusion sebacate seems to be a valuable new substrate for use in total parenteral nutrition and may have properties useful in special metabolic conditions. In this study, the urinary excretion of C10 and its products of β‐oxidation (suberic [C8] and adipic [C6]acids) was found to be low (totaling less than 16% of the administered dose) and the energy production high (6.64 kcal/g) with C10 being completely oxidized in the organism to CO2and H2O. (Journal of Parenteral and Enteral Nutrition16:32–38, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600132

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

摘要:

Early enteral feeding after injury is important for maintenance of gut integrity. However, enteral nutrients are frequently administered at low rates because of decreased gastrointestinal motility. These low rates are said to “maintain the gut.” This study was performed to evaluate the effect of rate of enteral nutrient delivery on gut mass.Six male Sprague‐Dawley rats had no surgery and served as controls (ad libitumrat chow diet). Twenty‐four male Sprague‐Dawley rats underwent abdominal surgery for placement of gastroduodenal feeding tubes (tip located 2 cm into intestine from pylorus) and were randomized (n = 6 per group)to ad libitumrat chow, 1/2 strength peptide diet (Reabilan HN, RHN) at 1 mL/h (1/2RHN‐1 mL), full‐strength peptide diet at 2 mL/h (RHN‐2 mL), or full‐strength peptide diet at 4 mL/ h (RHN‐4 mL). These diets supplied approximately 30%, 13%, 50%, and 100% of rat recommended daily allowances.The control animals gained weight (38 ± 3 g over 5 days) whereas all postsurgery animals lost weight. Weight loss was greatest in the 1/2 RHN‐1 mL (‐55 ± 3 g over 5 days) and RHN‐2 mL (‐52 ± 6 g over 5 days) groups compared with the RHN‐4 mL animals (‐41 ± 5 g over 5 days). All animals fed liquid enteral diets had reduced gut weights compared with chow‐fed animals. Gut weights did not differ between control and postsurgeryad libitumchow animals. Proximal gut mucosal protein content was significantly (p<.05) higher in the RHN‐4 mL animals (0.88 ± 0.03 mg/cm) compared with control (0.74 ± 0.003 mg/cm) andad libitumchow animals (0.73 ± 0.05 mg/ cm). There were no differences in mid‐ and distal gut mucosal protein levels between groups. We conclude that the rate of enteral feeding has little effect on gut mass in the early (5 day) postoperative period in rats. (Journal of Parenteral and Enteral Nutrition16:39–42, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600139

出版商:SAGE Publications    

年代:1992

数据来源: WILEY

摘要:

There is, at present, considerable interest in the possible role for the proinflammatory cytokines, tumor necrosis factor‐α, interleukin‐1, interleukin‐6, and interferon‐γ in the pathogenesis of cancer cachexia. Indirect evidence for such a role is based on the observation that chronic administration of many of these cytokines, either alone or in combination, can reproduce the myriad of host responses seen in experimental and human cancer cachexia. Elevated plasma levels of tumor necrosis factor‐α, interleukin‐1, and inteferon‐γ have rarely been detected in patients or experimental animals with cancer, although interleukin‐6 levels appear to correlate with tumor progression in animal models. The strongest evidence for a causal role for cytokines has come from rodent studies in which tumor‐bearing animals have been passively immunized with antibodies directed against individual cytokines. Several groups have shown modest but significant improvements in food intake and lean tissue retention with antibodies directed against tumor necrosis factor‐α, interleukin‐1, interleukin‐6, and interferon‐γ. However, there has been no consistent finding that one cytokine is universally involved in cancer cachexia in histologically distinct tumor models. One ominous finding in several tumor models has been that the endogenous production of cytokines appears to support tumor growth. Such findings raise the intriguing possibility that these cytokines, although contributors to tissue wasting and anorexia, may also serve the tumor as either direct or indirect cell growth factors. We conclude, however, that because of redundancy in the cytokine network and differential cytokine production in histologically distinct tumors, efforts to block the development of cancer cachexia with anticytokine therapies will require the inhibition of several proinflammatory cytokines simultaneously. (Journal of Parenteral and Enteral Nutrition16:43S‐49S, 1992)

ISSN:0148-6071    

DOI:10.1177/014860719201600602

出版商:SAGE Publications    

年代:1992

数据来源: WILEY