bluuebunny/crossref_metadata_2025 huggingface dataset:
Serotonin Receptors in the Brain following Total Hepatectomy in Rats Treated with Branched‐Chain Amino Acids
Authors: Bugge M. , Bengtsson F. , Hall H. , Wedel I. , Nobin A. , Jeppsson B. , Herlin P.
Published: May 2008

Serotonin concentrations and receptor binding characteristics were investigated in rats subjected to total hepatectomy, portacaval shunt (PCS) or sham‐operation. The animals were infused for 5 hr with a 10% glucose solution or the same solution enriched with 0.24 M branched‐chain amino acids (BCAA). Hepatectomized animals were in grade‐two coma at the end of the experiment independent of infusion. Indoleamines in mesencephalon‐pons and diencephalon were analyzed by high‐pressure liquid chromatography with electrochemical detection. Serotonin receptors (5‐HT1 and 5‐HT2) were investigated in the cortex and hippocampus by radioligand binding studies using 3H‐serotonin for analysis. of 5‐HT1receptors and 3H‐ketanserin for analysis of 5‐HT2‐receptors. Concentrations of serotonin (5‐HT) and 5‐hydroxyindoleacetic acid (5‐HIAA) were significantly increased after hepatectomy compared with controls. Treatment with BCAA significantly decreased 5‐HT and 5‐HIAA levels in hepatectomized animals. The affinity and the number of binding sites for the 5‐HT1 and 5‐HT2 receptors were found to be similar in all groups. The present study indicates that PCS for 1 week and the anhepatic state for 5 hr in rats do not influence brain serotonin receptors in contrast to previous studies in pigs with liver ischemia or rabbits with galactosamine‐induced liver damage. In addition, infusion of BCAA for 5 hr did not alter the binding characteristics. (Journal of Parenteral and Enteral Nutrition 13:235–239, 1989)
A Newborn Rabbit Model for Total Parenteral Nutrition: Effects of Nutritional Components on Cholestasis
Authors: Hata Shinsuke , Kamata Shinkichi , Nezu Rhchiro , Takagi Yoji , Okada Akira
Published: May 2008

A newborn rabbit model for total parenteral nutrition (TPN) was developed to examine the effects of nutritional components on cholestasis. Thirty‐five newborn Japanese white rabbits were divided into five groups. Rabbits in group I received glucose‐based TPN solution, Group II received lipid‐based solution, group III received larger amounts of amino acids than group I, and group IV received larger amounts of nonprotein calories than groups I and II. Rabbits in group V were given mother's milk freely. After the duration of TPN for 7 days, blood samples and liver were obtained when rabbits were killed. In group IV, the serum level of T‐Bil (1.44 ± 0.68 mg/dliter) was significantly higher than those in other groups (group I: 0.28 ± 0.04 mg/dl; group II: 0.49 ± 0.12 mg/dl; group III: 0.21 ± 0.04 mg/dl; group V: 0.28 ± 0.07 mg/dl), and serum level of GOT (44.2 ± 25.2 units) and total bile acid (20.6 ± 8.9 nmol/ml) were significantly higher than those in groups I, II, and III (group I: 16.8 ± 7.8 units and 6.7 ± 3.3 nmol/ml, group II: 21.5 ± 7.9 units and 12.5 ± 6.4 nmol/ml, group III: 14.3 ± 4.2 units and 8.4 ± 5.0 nmol/ml, respectively). Furthermore, there was histological cholestasis characterized by bile plugs in bile ducts, and bile pigments in Kupffer cells and hepatocytes, whereas there were no, or scarce findings of cholestasis in the other groups. These results indicate that an excessive administration of nonprotein calories in TPN contributes to the occurrence of cholestasis. In addition this animal model may be useful in investigating the etiology of cholestasis. (Journal of Parenteral and Enteral Nutrition 13 :265–271, 1989)
In Vitro Recovery of Carbamazepine from Ensure
Authors: Merali Kassam Rosemin , Friesen Erwin , Locock Robert A.
Published: May 2008

The in vitro recovery of three different dosage forms of carbamazepine (CBZ) when dispersed in gastric or intestinal fluids, in the presence or absence of Ensure was determined. An equivalent of 1 mg of pure CBZ from Tegretol 200 mg of conventional tablets, chewtablets of Tegretol 200‐mg and Apo‐carbamazepine (200‐mg tablets) were dispersed in five dissolution mediums (0.5 ml of Ensure; 0.5 ml of Ensure and 1.0 ml of gastric fluid; 1.0 ml of gastric fluid; 0.5 ml of Ensure and 1.0 ml of intestinal fluid; and 1.0 ml intestinal fluid) and mixed for 1 hr and filtered. The filtrates were then assayed for CBZ using a UV spectrophotometer. The mean recoveries of CBZ for all dosage forms in the various dissolution mediums were: Ensure/gastric fluid, 85%; gastric fluid, 75%, Ensure/intestinal fluid, 59%; intestinal fluid, 79%; and Ensure, 58%. The differences in CBZ recovery from gastric or intestinal fluid, in the presence or absence of Ensure were found to be statistically significant (p < 0.05). The difference in dosage forms were statistically not discernible. The significant differences observed in recoveries of CBZ due to Ensure warrants an in vivo study to realize the clinical implication of administering CBZ with Ensure. (Journal of Parenteral and Enteral Nutrition 13:272–276, 1989)
Preoperative Nutritional Assessment to Predict Postoperative Complication in Gastric Cancer Patients
Authors: Yamanaka Hideharu , Nishi Masaharu , Kanemaki Toshiki , Hosoda Nobumichi , Hioki Koshiro , Yamamoto Masakatsu
Published: May 2008

The correlation between preoperative nutritional parameters and postoperative complications in 440 patients with gastric cancer were analyzed. All the nutritional parameters reflected a significant deterioration as the stages of cancer progressed, and the frequency of postoperative complications was highest in patients with stage IV gastric cancer. The incidence of anastomotic leaks was increased in patients undergoing total gastrectomy with no relation to the clinical stage or nutritional status. However, there was a close relationship between nutritional status and immunocompetence, lung complications, and infection. The nutritional indices which reliably predicted preoperatively the nutritional status of cancer patients were the serum protein concentrations including the serum albumin (Alb) and prealbumin (PA). The indices predicting postoperative complications were the Alb, PA, and total lymphocyte count. These results suggest that preoperative nutritional assessment can be beneficial for the prediction of postoperative complications. (Journal of Parenteral and Enteral Nutrition 13:286–291, 1989)
The Effects of an Anabolic Steroid and Peripherally Administered Intravenous Nutrition in the Early Postoperative Period
Authors: Hansell Douglas T. , Davies John W.L. , Shenkin Alan , Garden O. James , Burns Henry J.G. , Carter David C.
Published: May 2008

Sixty patients undergoing colorectal surgery for malignancy were randomized to receive the anabolic steroid stanozolol (n = 30) or to a control group (n = 30). Patients were further randomized to receive on the first 4 postoperative days a) a standard dextrose‐saline regimen (DS), b) an amino acid regimen (AA), or c) a glucose‐amino acid‐fat regimen (GAF) via a peripheral vein. Fat and carbohydrate oxidation rates were calculated pre‐ and postoperatively using indirect calorimetry. Postoperative nitrogen balance (NB) in patients receiving amino acids was significantly improved (p < 0.02) by the administration of stanozolol. Fat and carbohydrate oxidation rates were not significantly affected by stanozolol. Patients in the stanozolol and control AA groups showed a fall in carbohydrate oxidation (p < 0.01) and a rise in fat oxidation (p < 0.05) postoperatively, whereas no significant changes in fat and carbohydrate oxidation occurred in the two DS and two GAF groups. Cumulative NB for the first 4 postoperative days was significantly better (p < 0.01) in the two AA groups than in the two DS groups, due to an improved NB in the two AA groups on the 1st and 2nd days only. Cumulative NB in the two GAF groups was significantly better (p < 0.01) than in all the other groups. This study shows that stanozolol improves postoperative NB in patients receiving amino acids alone, whereas the provision of a more complete nutritional regimen containing glucose, amino acids, and fat results in a positive NB unaffected by stanozolol. (Journal of Parenteral and Enteral Nutrition 13:349–358, 1989)
Effects of Parenteral Nutrition on Whole Body and Extremity Composition in Children and Adolescents with Active Inflammatory Bowel Disease
Authors: Lin Chuan‐Hoa , Lerner Aaron , Rossi Thomas M. , Feld Leonard G. , Riddlesberger Merchline M. , Lebenthal Emanuel
Published: May 2008

The effect of parenteral nutrition (PN), combined with corticosteroid therapy, on body composition was evaluated in 22 pediatric patients with active and complicated inflammatory bowel disease (IBD). The patients were divided into two groups according to the duration of PN. Group A consisted of 14 patients who received PN for an average of 43 days (short term) whereas eight patients received PN for an average of 104 days (long term); group B. Nutritional assessments were performed before and following the PN periods. In addition, a follow‐up assessment was performed 50 days after the cessation of PN for group A. Serial evaluations included; weight, height, disease activity score, arm anthropometry, sub‐scapular skinfold (SSSF) thickness, 24‐hr urinary creatinine, and computed tomography (CT) scan of the thigh. Following PN with a glucose‐fat mixture used as a nonprotein energy source, there were significant (p < 0.05) increases in weight, SSSF, and muscle mass (MM) in both groups. Disease activity declined in both groups and height increased in group B and at the follow‐up assessment for group A. Considering extremity composition, both groups exhibited increases in midarm muscle area, midarm fat area, thigh muscle area, and thigh fat area. However, a differential distribution of incremental change was observed depending on the duration of PN. Fat deposition predominated in both the upper and lower extremities for group A. Group B patients, however, although showing a predominance of fat accumulation in the upper extremities, gained muscle and fat components equally in the lower extremities. The results indicate that the weight gain observed following the use of PN in patients with active and complicated IBD represents a deposition of muscle and fat at both whole body and extremity level and point out the importance of supplying glucose and fat as nonprotein energy sources in order to achieve better body composition. (Journal of Parenteral and Enteral Nutrition 13:366–371, 1989)
Effect of Whey Proteins, Their Oligopeptide Hydrolysates and Free Amino Acid Mixtures on Growth and Nitrogen Retention in Fed and Starved Rats
Authors: Poullain Marie‐Gwenaelle , Cezard Jean‐Pierre , Roger Loic , Mendy Francois
Published: May 2008

The effects of alimentary whey proteins given, as whole proteins (WP), controlled trypsin and chymotrypsin hydrolysate oligopeptides (WPH), or a free amino acid mixture (AAM), on the growth, nitrogen retention, and steatorrhea were assessed in 24 Wistar rats (250 to 300 g) after 72 hr of starvation and 24 to 96 hr of realimentation and in 24 controls. The three diets had the same caloric, nitrogen, vitamin, and mineral contents. Rats had free access to the liquid diets. Only rats which ate the whole diet (90 cal) were included in the study. No differences in steatorrhea and fecal nitrogen were observed. The absorption rate was over 95% on the three diets. In contrast, weight gain was statistically better on WPH (+9% after 96 hr of realimentation) than on WP (+5%) or AAM (+2%). This was associated with a statistically higher nitrogen retention at all time periods studied, which was a result of a significant lower nitrogen urinary excretion. Similar results were obtained in controls. This better growth was a result of a better protein synthesis and lower ureagenesis. (Journal of Parenteral and Enteral Nutrition 13:382–386, 1989)
Insulin‐Like Growth Factor‐I in Human Malnutrition: Relationship with Some Body Composition and Nutritional Parameters
Authors: Minuto Francesco , Barreca Antonina , Adami Gian Franco , Fortini Patricia , Del Monte Patrizia , Cella Franca , Scopinaro Nicola , Giordano Giulio
Published: May 2008

The insulin‐like growth factor‐I (IGF‐I) plasma concentration was evaluated as a nutritional parameter in 18 patients affected with chronic malnutrition secondary to biliopancreatic bypass and compared with albumin, transferrin, and with body composition parameters: total body water (TBW), total body sodium (TBNa), total body potassium (TBK). Subjects were studied in malnutritional conditions and after 20 to 30 days of parenteral and enteral refeeding treatment. Immunoreactive IGF‐I concentration was 0.35 U/ml ± 0.07 (mean ± SEM), significantly lower (p < 0.01) than in age‐matched controls (1.14 ± 0.07 U/ml, n = 29) and rose significantly (0.84 ± 0.12 U/ml; p < 0.01) in parallel with the improvement of nutritional status. The ratios TBNa/TBW, TBNa/ TBK, and TBK/TBW were then considered as reference parameters for definition of malnutritional state, and compared with IGF‐I as well as with the most commonly used parameters, albumin and transferrin. Before treatment, IGF‐I evidenced higher specificity (true negative ratios 0.63, 0.43, and 0.40 with regard to TBNa/TBW, TBNa/TBK, and TBK/TBW, respectively) than albumin (0.13, 0.14, and 0.10) and transferrin (0 in all cases), and slightly less sensitivity (true positive ratios for IGF‐I 0.80, 0.67, and 0.67; always one for albumin and transferrin). Moreover, IGF‐I resulted definitely more sensitive in assessing the effectiveness of the refeeding treatment and, on the basis of the likelihood ratio, it appeared a good discriminator of the nutritional status. The data indicate that different nutritional factors regulate IGF‐I, albumin, and transferrin, and suggest that IGF‐I can be used as a reliable and specific nutritional parameter, complementary to the others currently used. (Journal of Parenteral and Enteral Nutrition 13:392–396, 1989)
Central Venous Thrombosis Related to the Silastic Hickman‐Broviac Catheter in an Oncologic Population
Authors: Moss Jerry F. , Wagman Lawrence D. , Rhimaki Daniel U. , Terz Jose J.
Published: May 2008

The use of subcutaneously implanted, Dacron cuffed, central venous silastic catheters (Hickman/Broviac catheter [HC/BC]) has not eliminated catheter related‐central venous thrombosis (CR‐CVT). HC/BC related CR‐CVT was identified and followed in 15 oncology patients. Median time period to CR‐CVT was 155 days (range 15–638). No correlation was established to patient age, sex, diagnosis, coagulation status, use, longevity, technique, or site of placement. Fourteen patients were treated with anticoagulation and/or thrombolytic therapy. Of seven patients treated with HC/BC in situ, one required HC/BC removal to achieve CR‐CVT resolution. Median follow‐up post‐CR‐CVT was 362 days (range 34–1622). No patient suffered untoward long‐term sequelae. Nine patients had 11 catheters placed following resolution of CR‐CVT. None had repeat thrombosis. CR‐CVT incidence in a single 12‐month period was 3.7% (7/190). The placement of HC/BC in an oncology population is an acceptably safe method for long‐term venous access. (Journal of Parenteral and Enteral Nutrition 13:397–400, 1989)
Copper Deficiency during Total Parenteral Nutrition: Clinical Analysis of Three Cases
Authors: Fujita Muneyuki , Itakura Takeo , Takagi Yoji , Okada Akira
Published: May 2008

Three adult cases in which copper deficiency developed during long‐term total parenteral nutrition (TPN) without copper supplementation have been described, together with a brief review of the literature. All three patients were suffering from malabsorption when TPN was instituted, and overt symptoms of copper deficiency developed an average of 5.8 months after the start of TPN. Clinically, leukopenia with neutropenia and low plasma levels of copper and ceruloplasmin were seen in all cases. The dosage of copper administration in these cases was 0.3 to 7.2 mg of copper/day, or 5.3 to 133 μg of copper/kg/day, with total doses of 7 to 176 mg of copper. (Journal of Parenteral and Enteral Nutrition 13:421–425, 1989)
Serial Plasma and Urinary Aluminum Levels and Tissue Loading in Preterm Twins
Authors: Bozynski Mary Ellen A. , Sedman Aileen B. , Naglie Ronald A. , Wright Eileen J.
Published: May 2008

Serial plasma, urinary, and postmortem tissue aluminum levels were determined in 32‐week, appropriate‐forgestational‐age twins from 45 to 151 days postnatal age. Estimated total aluminum absorptions were 56.7 mg, and 28 mg, twin A and twin B, respectively.

At autopsy, Twin A had a hypoplastic right kidney while Twin B had normal kidneys. Mean plasma aluminum levels (twin A, 34.2 μg/liter and twin B, 32.3 μg/liter) and urinary aluminum levels expressed as aluminum creatinine ratios (twin A, 11.3 and twin B, 8.5) were similar. These levels were elevated compared to normal plasma aluminum levels of 5.1 ± 3.6 (1 SD) and urinary aluminum creatinine ratios of 0.64 ± 0.75 (1 SD). Twin A had higher tissue aluminum levels than twin B in all tissues except for brain. Bone and liver aluminum contents for both twins were increased as compared to infants receiving short‐term or no parenteral nutrition. We conclude; (1) tissue aluminum loading occurs in infants receiving aluminum‐containing solutions, (2) plasma and urinary aluminum levels are poor predictors of tissue aluminum content, (3) enteral solutions may add significant aluminum exposure. (Journal of Parenteral and Enteral Nutrition 13:428–431, 1989)
Effect of Administered Human Growth Hormone on Protein Metabolism in Septic Rats
Authors: Okamura Kenji , Okuma Toshitada , Tabira Yoichi , Miyauchi Yoshimasa
Published: May 2008

The effect of administered human growth hormone (hGH) on protein metabolism in septic rats was investigated. Fifty‐three male Wistar rates with SVC cannulation were divided into four groups. Group I (n = 10) underwent sham‐operation. Sepsis was induced by cecal ligation in group II (n = 19), group III (n = 10), and group IV (n =14). Isocaloric, isonitrogenous glucose/amino acids were infused for 4 days. hGH was administered in group III (100 mU/day) and group IV (200 mU/day) every day. Cumulative nitrogen balance (mg/ kg) in group IV was significantly higher than in group II (p < 0.01): group I, 1264 ± 355; group II, 117 ± 693; group III, 92 ± 735; group IV, 1001 ± 279. Cumulative urinary excretion of 3‐methylhistidine (3‐MH, mg/kg) did not differ between group II and group IV: group I, 6.2 ± 0.9; group II, 12.0 ± 2.2; group III, 13.4 ± 2.9; group IV, 10.5 ± 2.3. Serum albumin level in group IV (1.8 ± 0.2 g/dl) was significantly higher than in group II (1.5 ± 0.2 g/dl) (p < 0.01). Blood urea nitrogen level in group IV (12.6 ± 2.3 mg/dl) was significantly lower than in group II (18.8 ± 7.4 mg/dl) (p < 0.05). Although serum levels of glucose, insulin, triglyceride, and phospholipid were higher in sepsis groups than in sham‐operated group, those levels did not differ among sepsis groups. Administration of hGH, 200 mU/day, resulted in marked nitrogen retention and had little effect on 3‐MH excretion. These data suggest that exogenously administered growth hormone mainly favors the conservation of visceral protein compartment in the septic state. (Journal of Parenteral and Enteral Nutrition 13:450–454, 1989)
Vitamin Plasma Levels in Long‐Term Enteral Feeding Patients
Authors: Berner Yitshal , Morse Rachel , Frank Oscar , Baker Herman , Shike Moshe
Published: May 2008

Plasma levels of vitamins were determined in eight patients who were nourished with long‐term enteral feeding using commercial formulas. The type and quantity of the formula were individually tailored to the patients' needs. Caloric intake (mean ± SEM) amounted to 1564 ± 97 kcal/day. Vitamins intake from the formulas, expressed as percent of Recommended Daily Allowances (RDA), was as follows: pantothenic acid, 222 ± 44%; vitamin B12, 206 ± 34%; vitamin C, 376±51%; thiamine, 207± 34%; niacin, 207± 34%; riboflavin, 207 ± 34%; pyridoxine, 222 ± 17%; biotin, 113 ± 13%; vitamin A, 93 ± 4%; and folic acid, 104 ± 14%. Plasma levels of thiamine, riboflavin, pyridoxine, pantothenic acid, folic acid, and vitamin B12 were within normal limits in all patients. Two patients had lower than normal plasma levels of nicotinic acid despite the high intake. Plasma biotin levels were above normal in all patients, with a mean of 931 ± 140 pg/ml (N: 200–500 pg/ml). Ascorbic acid levels were within or above normal, but no correlation with intake was found. Carotene levels were measured in five patients and found to be below the lower limit of normal, a reflection of lack of intake from the enteral formulas. The plasma vitamin A levels were normal in all patients. It is concluded that feeding with commercial enteral formulas results in normal plasma levels of vitamins in patients maintained on these formulas for over 6 months. The excessive amounts of vitamins in the formulas do not result in elevated plasma levels, except for Biotin. (Journal of Parenteral and Enteral Nutrition 13:525–528, 1989)
Identifying ICU Patients Who Would Not Benefit from Total Parenteral Nutrition
Authors: Chang Rene W.S. , Lee Berni , Jacobs Sydney
Published: May 2008

This study attempted to improve patient selection for total parenteral nutrition (TPN) by identifying ICU patients whose prognoses were so hopeless that they would not or would no longer benefit from TPN. Computerized trend analysis of daily Apache II scores, corrected for the presence, number, and duration of major organ system failures was used to predict individual hospital outcome among 50 intensive care unit patients treated with TPN. Thirteen of the 18 deaths were correctly predicted without any false predictions. During the study, the results of predictions were not used to influence clinical decision making. If TPN was withheld in the five patients predicted to die before starting TPN, or withdrawn in the eight patients when they were predicted to die, $28,350 or 11.5% of the cost of TPN during the study period would have been saved. This hypothetical study shows that elimination of inappropriate treatment of patients with hopeless prognosis with the aim of avoiding the prolongation of the process of dying and unnecessary suffering is a compassionate patient‐selection strategy that can result in major savings in healthcare resources. (Journal of Parenteral and Enteral Nutrition 13:535–538, 1989)
Review: Parenteral Nutrition in Patients with Diabetes Mellitus: Theoretical and Practical Considerations
Authors: Mcmahon Molly , Manji Nasrullah , Driscoll David F. , Bistrian Bruce R.
Published: May 2008

It is estimated that there are 11 million diabetics in the United States. Increasing recognition of the importance of nutrition in clinical medicine coupled with the frequent hospitalizations of the diabetic patient has heightened interest in their nutritional therapy. Patients with diabetes mellitus exhibit many abnormalities in the regulation of carbohydrate metabolism which may be accentuated during illness as part of the metabolic response to injury. An understanding of the effect of injury/illness, parenteral nutrition, and diabetes mellitus on carbohydrate metabolism is essential for the development of a rational approach to the initiation and maintenance of nutritional support in the diabetic patient.(Journal of Parenteral and Enteral Nutrition13:545–553, 1989)
Cologastric Fistula as a Complication of Percutaneous Endoscopic Gastrostomy
Authors: Stefan Michael M. , Holcomb George W. , Ross Arthur J.
Published: May 2008

Percutaneous endoscopic gastrostomy (PEG) is frequently used for long‐term enteral nutrition or gastrointestinal decompression in both adults and children. The rare complication of a cologastric fistula following PEG has been seen recently in two pediatric patients. One fistula did not close after removal of the gastrostomy tube. A mechanism for the occurrence of this complication in these two children is proposed and technical points are emphasized to prevent this complication. (Journal of Parenteral and Enteral Nutrition 13:554–556, 1989)
Effects of Protein Malnutrition and Endotoxin on the Intestinal Mucosal Barrier to the Translocation of Indigenous Flora in Mice
Authors: Ma Li  , Specian Robert D. , Berg Rodney D. , Deitch Edwin A.
Published: May 2008

Since protein malnourished or endotoxemic patients are at increased risk of developing nosocomial infections with enteric organisms, we investigated the effects of these risk factors alone and in combination on the intestinal mucosal barrier to bacteria. Protein malnutrition resulted in severe ileal atrophy that was directly related to the length of time the mice were protein malnourished. Although protein malnutrition did not promote bacterial translocation from the gut to systemic organs, the protein‐malnourished mice were more susceptible to endotoxin‐induced bacterial translocation than normally nourished mice (p < 0.01). Since the gross epithelial damage documented after endotoxin administration in normally nourished mice was diminished after protein malnutrition, there was no correlation between the gross appearance of the epithelial mucosal barrier and the extent of endotoxin‐induced bacterial translocation. These results suggest that the synergistic effect of endotoxin plus protein malnutrition on bacterial translocation is not primarily related to failure of the gut mucosal barrier. Nonetheless, it appears that protein‐malnourished mice are less able to clear translocating bacteria than normally nourished mice. (Journal of Parenteral and Enteral Nutrition 13:572–578, 1989)
Differential Effects of Parenteral Nutrition on Tumor Growth and Erythrocyte Polyamine Levels in the Rat
Authors: Grossie V. Bruce , Nishioka Kenji , Chang Tai‐Hwa , Patenia Domitila , Benitez Maday M. , Ajani Jaffer A. , Ota David M.
Published: May 2008

The influence of total parenteral nutrition (TPN) on tumor growth and erythrocyte polyamine levels was evaluated in rats with a transplantable fibrosarcoma or a Ward colon tumor. During the experimental periods the fibrosarcoma grows exponentially when rats are fed chow ad libitum while the colon tumor reaches a plateau of its Gompertzian growth curve. A 12‐day regimen of TPN resulted in an increased growth of the colon tumor but not the fibrosarcoma. The erythrocyte putrescine levels of fibrosarcoma‐bearing rats and the levels of putrescine, spermidine, and spermine of Ward colon‐tumor‐bearing rats were significantly increased by TPN compared with similarly treated nontumor‐bearing (NTB) rats. When the growth of the fibrosarcoma was slowed by feeding a restricted intake (RI) regimen, a subsequent 6‐day regimen of TPN resulted in increased tumor growth. Erythrocyte polyamine levels of fibrosarcoma‐bearing, RI‐rats were elevated by TPN repletion. There was a consistent, significant, interaction between TPN and tumor presence on the erythrocyte putrescine levels in fibrosarcoma‐bearing rats and the levels of all polyamines in Ward colon‐tumor‐bearing rats. The effects of TPN on tumor growth and erythrocyte polyamine levels of tumor‐bearing rats may be dependent on the growth characteristics of the tumor. The data demonstrate that TPN consistently enhanced the tumor contribution to the erythrocyte putrescine pool. (Journal of Parenteral and Enteral Nutrition 13:590–595, 1989)
Effects of Overfeeding in Children with Muscle Dystrophies
Authors: Goldstein Mara , Meyer Shirley , Freund Herbert R.
Published: May 2008

In muscle dystrophies as in other muscle‐wasting diseases and states, a progressive loss of muscle protein occurs, probably as a result of an imbalance between muscle protein synthesis and degradation.

In the present study we examined whether this progressive muscle wasting and reduced functional capacity so damaging to patients with muscular dystrophies, can be reduced or even reversed by nightly overfeeding with 1000 ml of Osmolite in addition to the voluntary daytime dietary intake.

In the Duchenne muscle dystrophy (DMD) group (six patients) body weight increased significantly accompanied by a 14% increase in midarm muscle circumference with only minimal changes in triceps skin fold, indicating a relative build up of muscle mass. In the congenital muscular dystrophy (CMD) group (four patients) no changes occurred in body weight or any of the three anthropometric measurements performed. Baseline nitrogen balance was mildly positive in both groups and improved significantly in the DMD group during the 3‐month experimental period of refeeding, with no changes in urinary 3‐methylhistidine excretion, suggesting improved muscle protein synthesis with no change in muscle protein degradation. No changes were detected in hematological and biochemical parameters, liver function tests, pulmonary function tests, or a general activity index during the study period.

Our results suggest that a reduced rate of protein synthesis rather than an increased rate of protein degradation occur in muscle dystrophies, and that overfeeding might offer promising nutritional effects, at least in DMD patients. (Journal of Parenteral and Enteral Nutrition 13:603–607, 1989)
Beneficial Effect of Coinfusing a Lipid Emulsion on Venous Patency
Authors: Pineault Marjolain , Chessex Philippe , Piedboeuf Bruno , Bisaillon Suzanne
Published: May 2008

The hypothesis that infused fat could prolong venous patency was tested in a paired crossover design. Parenterally fed newborn infants received, for a given level of energy, (60 vs 80 kcal/kg/day), two 6‐day isocaloric and isonitrogenous (434±3.4 mg/kg/day, n=32) regimens differing only by the fat intake (LF: 1.03±0.02, HF: 2.78±0.05 g/kg/day). Paired comparisons of osmolarities within isocaloric (60 or 80 kcal/kg/day) infusions showed that high fat regimens were associated with significantly lower osmolarities. A paired comparison of patency times showed that the drop in osmolarity produced by the high fat regimen at 60 kcal/kg/day led to a significantly longer venous patency time. The comparison of patency times between regimens (LF, 60 kcal/kg/day) and HF, 80 kcal/kg/day) with same osmolarities (702 mOsm/liter) and glucose intakes (11 g/kg/day) documented that the fat emulsion per se had a vascular protective effect. This observation demonstrates that the coinfusion of a lipid emulsion exerts a beneficial effect, whether biochemical or biophysical, on the vascular endothelium of peripheral veins. (Journal of Parenteral and Enteral Nutrition 13:637–640, 1989)
Subdural Intravenous Fat Collection: An Unusual Complication of Central Intravenous Feeding in the Neonate
Authors: Young Sarah , Macmahon P. , Kovar I.Z.
Published: May 2008

We report on a very low birth weight preterm infant who developed a subdural collection of infusion lipid while receiving total parenteral nutrition. A possible mechanism is outlined. (Journal of Parenteral and Enteral Nutrition 13:661–662, 1989)
Effect of commercially available chemically defined liquid diets on the intestinal microflora and bacterial translocation from the gut
Authors: Alverdy JC , Aoys E , Moss GS
Published: May 2008

The effect of chemically defined liquid diets on the intestinal microflora and bacterial translocation from the gut was studied in the rat. Seventy‐five female Fischer rats were randomized to five groups of 15 animals each. Group I was fed rat chow and water, group II was fed Vivonex TEN, group III was fed Ensure, group IV was fed Enrich, and group V was fed Ensure plus ground corn cobs, a crude fiber source. Animals were fed their respective diets ad libitum for 1 week and then killed. Quantitative culture of the mesenteric lymph nodes (MLN) and cecum was performed to determine bacterial translocation from the gut. A 66% translocation rate (10/15) of bacteria to MLN was observed in the animals fed Ensure and Enrich compared to 21% in the Vivonex TEN group (3/14) and 20% in the animals fed Ensure plus ground corn cobs (3/15). None of the animals in the control group eating their normal diets of rat chow and water developed positive MLN. Statistical significance (p less than 0.001) was achieved between the Ensure and Enrich groups when compared to controls but not between the Vivonex TEN and Ensure plus corn cobs. Cecal culture revealed a statistically significant rise in cecal bacteria in all groups when compared to the control group (group I). These results indicate that chemically defined liquid diets result in altered intestinal microflora and bacterial translocation from the gut.
Fatty acid composition of adipocyte membrane phospholipids and stored triglycerides in infants receiving total parenteral nutrition
Authors: Harant I , Ghisolfi J , Couvaras O , Garcia J , Vaysse P , Thouvenot JP
Published: May 2008

Fatty acid (FA) composition of membrane phospholipids (PL) and stored triglycerides (TG) from adipose tissue was studied in eight infants aged 1 to 4 months receiving total parenteral nutrition (TPN) since birth. During this period, essential fatty acid (EFA) intake consisted exclusively of soybean oil emulsion administered by intravenous route (Intralipid 20%) representing 301 +/‐ 88 mg/kg/24 hr of linoleic acid and 58 +/‐ 18 mg/kg/24 hr of alpha‐linolenic acid, or 2.3 +/‐ 0.6% and 0.4 +/‐ 0.1%, respectively, of total energy intake. The results were compared with those of eight control infants of the same age receiving orally a normal milk diet with an intake of 660 +/‐ 260 mg/kg/24 hr of linoleic acid and 101 +/‐ 35 mg/kg/24 hr of alpha‐linolenic acid, or 4.5 +/‐ 0.7% and 0.7 +/‐ 0.3%, respectively, of total energy intake. Although their EFA intake was significantly lower (p less than 0.01) and administered only parenterally, after 1 to 4 months the infants receiving TPN still had a membrane phospholipid FA pattern of adipose tissue which was not significantly different from that of normal children of the same age. In stored adipocyte TG, the percentage of linoleic acid was significantly lower (p less than 0.01) in infants receiving TPN. This is probably of nutritional importance as at this stage of life the child builds up its stores of EFA. The proportion of the other fatty acids in adipocyte TG was not significantly modified.
Reliability of the twenty‐four‐hour nitrogen balance in parenterally fed newborn infants
Authors: Pineault M , Maag U , Chessex P
Published: May 2008

The reliability of shorter nitrogen balance determinations was evaluated in order to facilitate the nutritional assessment of parenterally fed infants. The intraindividual day‐to‐day variations of nitrogen intake, excretion, and retention were analyzed in 23 parenterally fed newborn infants (birth weight: 785–2630 g). Nitrogen retentions measured over 3 consecutive days were highly correlated (r = 0.90–0.96), and the reliability for a single 24‐hr collection was estimated by r1 = 0.93. Nitrogen balance data obtained over a 24‐hr period are reliable for the purpose of clinical investigations, provided the nutrient intake is constant.
Comparative clearance of two new fat emulsions‐‐Hausmann Lipid 20% and Lipovenos 20%‐‐versus intralipid 20%
Authors: Pichard C , Johner B , Pilet M , Temler E , Roulet M
Published: May 2008

Intravenous fat tolerance tests (IVFTT) were performed in 13 healthy men volunteers once a day during three consecutive days in order to compare three different fat emulsions randomly administered (Intralipid 20%, Hausmann Lipid 20%, Lipovenos 20%). The amount of fat was 0.1 g/kg of body weight injected within 32 +/‐ 4 sec and the lipid clearance was determined over 40 min. The fractional removal rates k for the three different emulsions of fat were 5.38 +/‐ 1.67, 4.95 +/‐ 2.15, 3.92 +/‐ 1.31 %/min, respectively (mean +/‐ SD), and the half‐life time of clearance T1/2 were 14.5 +/‐ 5.8, 16.9 +/‐ 7.4, 19.2 +/‐ 5.2 min, respectively. The highest fat particles values were observed 5 min after the bolus and all concentrations remained within the normal range (0–3 g/liter) during the study. In addition, no adverse effects were observed throughout the IVFTT. The nonparametric analysis of variance (Friedman's test) showed no significant differences between groups, even if Lipovenos 20% tended to be cleared more slowly than Intralipid 20%. These results suggest that the three fat emulsions are similarly eliminated from the blood stream and do not result in acute intolerance. Further studies based on prolonged infusion should be carried out to determine whether the two new emulsions might be alternatively used for intravenous nutritional support.
Anabolic steroids in polytrauma patients. Influence on renal nitrogen and amino acid losses: a double‐blind study
Authors: Hausmann DF , Nutz V , Rommelsheim K , Caspari R , Mosebach KO
Published: May 2008

Severe trauma leads to considerable losses of nitrogen in the first days after the accident. As nutritional efforts cannot reduce these losses sufficiently, an adjunctive therapy using the anabolic steroid nandrolone decanoate (Nd) was applied. In a double‐blind study 10 male multiple‐traumatized patients each received 50 mg of Nd on day 3 and 25 mg of Nd on day 6 after the trauma, an additional 10 patients received placebo only. Both groups had identical nutritional support. Nitrogen balance, total nitrogen excretion as well as plasma amino acid concentration, and urine amino acid excretion were measured daily. The anabolic agent improved the nitrogen balance mainly by reducing nitrogen excretion. 3‐Methylhistidine excretion and renal amino acid losses were decreased. Nandrolone decanoate increased the concentration of total plasma amino acids. The underlying principle seems to be an amino acid‐saving mechanism with a renal site of action. It is shown that in the early posttraumatic period nandrolone decanoate improves nitrogen metabolism. Further studies are required to determine whether this offers a clinical benefit to trauma patients.
Nutritional effects of branched‐chain amino acids on injured rats in total parenteral nutrition
Authors: Iwasawa Y , Kishi T , Morita M , Ikeda K , Shima H , Sato T
Published: May 2008

In this study, we investigated the optimal contents of branched‐chain amino acids (BCAA) in a balanced amino acid infusion in laparotomized rats. The BCAA contents of four infusion solutions used were prepared to 22, 31, 40, and 49% of total amino acids, respectively. The amounts of essential amino acids except for BCAA were equal in all the solutions. Rats weighing about 240 g were infused with about 200 mg of nitrogen and 10 g of glucose daily for 7 days and evaluated for body weight change, nitrogen balance, plasma and urinary amino acid levels, and plasma constituent levels. The body weights of all the groups were approximately maintained during the infusion period. The nitrogen balance of the BCAA‐31 group was more positive than that of the BCAA‐22 group and was not different from those of the BCAA‐40 and BCAA‐49 groups. Plasma total‐protein level of the BCAA‐31 group was higher than that of the BCAA‐22 group and was equal to those of the BCAA‐40 and BCAA‐49 groups. Even when the BCAA content in an amino acid infusion was increased, no abnormal elevation was observed in plasma BCAA levels. There were no differences in the other nutritional parameters among the four infusion groups. These results suggest that the BCAA contents in an amino acid infusion are enough at 31% of total amino acids for this injured rat model.
Serum vitamin A and E concentrations in pediatric total parenteral nutrition patients
Authors: Hack SL , Merritt RJ , Morgan RM , Keefe MT
Published: May 2008

There is uncertainty as to optimal doses of fat soluble vitamins required by pediatric total parenteral nutrition (TPN) patients. We compared serum vitamin A (A) and E (E) concentrations analyzed by HPLC in chronic (greater than 2 weeks) TPN patients aged 1 month to 12 years to values obtained in out‐patient surgery patients of the same age. TPN patients received 1500 micrograms of retinol and 2.5 IU of E as alpha‐tocopheryl acetate (2.5 ml LyphoMed Multi Vitamin Concentrate). These doses were 214% of the recommended dose of A and 36% for E. Oral intake was minimal in most patients. The results of our study revealed a mean serum A level for TPN patients (N = 29) of 26.0 +/‐ 15.0 (SD) micrograms/dl vs 25.0 +/‐ 10.0 (SD) micrograms/dl in controls (N = 52). Mean serum E was 0.63 +/‐ 0.24 (SD) mg/dl vs 0.89 +/‐ 0.31 (SD) mg/dl for TPN patients and controls, respectively. There was no consistent trend related to duration of TPN for 23 patients with serial values. Seven (24%) TPN patients had serum A greater than mean + 2 SD of control (p less than 0.01). No values were less than mean ‐ 2 SD. Infants on TPN had a significantly lower mean serum A (22.3 +/‐ 10.9 micrograms/dl) than TPN patients greater than 1 year of age (34.1 +/‐ 16.0 micrograms/dl; p less than 0.001). Fifty‐two percent of TPN patients vs 26% of control had serum A less than 20 micrograms/dl (p greater than 0.1). For E, one patient had a high value and two patients low values relative to control.(ABSTRACT TRUNCATED AT 250 WORDS)
Differential Effects of Three Enteral Dietary Regimens on Selected Outcome Variables in Burn Patients
Authors: Gottschlich Michele M. , Jenkins Marilyn , Warden Glenn D. , Baumer Theresa , Havens Pamela , Snook Jean T. , Alexander J. Wesley
Published: May 2008

A modular tube feeding recipe (MTF) was designed to meet the unique nutritional needs of burn patients, applying principles previously documented in our burned guinea pig model. MTF, a high‐protein, low‐fat, linoleic acid‐restricted formulation is enriched with omega‐3 fatty acids, arginine, cysteine, histidine, vitamin A, zinc, and ascorbic acid. Fifty patients, 3 to 76 years of age with burns ranging from 10 to 89% total body surface area were prospectively randomized into three groups which blindly compared MTF to two enteral regimens widely utilized in the nutritional support of burns. Age, percent total and third‐degree burn, resting energy expenditure, and calorie and protein intake were similar in all groups. Data analysis demonstrated significant superiority of MTF in the reduction of wound infection (p < 0.03) and length of stay/percent burn (p < 0.02). MTF was also associated with a decreased incidence of diarrhea, improved glucose tolerance, lower serum triglycerides, reduced total number of infectious episodes and trends toward improved preservation of muscle mass, although statistical significance was not achieved. Seventy percent of deaths occurred in the group supported with an inherently large dose of fat and linoleic acid. Combining these observations, it is believed that MTF is effective in modulating an improved response to burn injury. (Journal of Parenteral and Enteral Nutrition 14:225–236, 1990)
A Double‐Blind Clinical Trial Comparing the Gastrointestinal Side Effects of Two Enteral Feeding Formulas
Authors: Viall Carolyn , Porcelli Karen , Teran J. Carlos , Varma Raj N. , Steffee William P.
Published: May 2008

Adequate enteral nutritional support is often limited by gastrointestinal (GI) side effects. In this pilot clinical trial we compared an enteral nutrition formula based on soy hydrolysate (study formula, SF) against a widely used intact casein formula (control formula, CF) for the incidence of GI side effects in a completely randomized double blind design. Twenty‐three nonsurgical hospitalized patients requiring enteral nutritional support and free of GI symptoms were randomly assigned to receive either the CF or the SF for 6 days continuously. Both formulas were isotonic, low in residue, lactose free and isocaloric, but differed in the type and concentration of protein and the concentration of medium‐chain triglycerides. After randomization both groups were comparable in demographic characteristics, and nutritional status, but there were more patients on antibiotics in the CF group. The amount of formula infused per day and the route of administration were equivalent. The number of bowel movements per day was 1.0 ± 0.5 for the CF group and 0.6 ± 0.3 for the SF group (p < 0.05). The incidence of diarrhea was 10.8% days for the CF group and 6.2% for the SF group (p = NS). High gastric residuals occurred in 16.9% of days in the CF group and 3.3% in the SF group (p < 0.05). Vomiting incidence was 10.8% in the CF group and 1.5% in the SF group (p < 0.05). After adjustment for the use of antibiotics as a covariate, the differences in number of bowel movements, vomiting and incidence of high residuals became less significant (p < 0.10). No differences were found among groups in other digestive or mechanical complications and no significant change occurred in nutritional or metabolic status during the study. The nitrogen retention per gram of nitrogen intake was similar for both groups and the soy based formula produced a state of positive nitrogen balance similar to the casein‐based formula. We believe that further studies with larger sample sizes are needed to clarify clinical advantages to soy hydrolysate formulas. (Journal of Parenteral and Enteral Nutrition 14:265–269, 1990)
Improved Selenium, Carnitine and Taurine Status in an Enterally Fed Population
Authors: Fischer Milton H. , Adkins William N. , Scaman Pat , Marlett Judith A.
Published: May 2008

Ten adult, male, nonambulant and gastrostomy‐fed individuals had received commercially available enteral feedings containing negligible amounts of selenium, carnitine, and taurine for an average of 59 months. Blood levels of these three nutrients were below published normal ranges as were the urinary excretions of carnitine and taurine. After 9 weeks on a product that was fortified with 23 μg of selenium, 39 mg of carnitine, and 38 mg of taurine per 8 ounces, blood levels were significantly increased with the levels of selenium and carnitine being normalized. (Journal of Parenteral and Enteral Nutrition 14:270–274, 1990)
Effect of pH on the Equilibrium Dialysis of Phenytoin Suspension with and without Enteral Feeding Formula
Authors: Splinter Michele Y. , Seifert Charles F. , Bradberry J. Christopher , Tu Yu‐Hsing , Allen Loyd V.
Published: May 2008

Significant decreases have been reported in phenytoin absorption when the suspension is combined with continuous enteral feedings. Several theories for this interaction have been proposed including binding of phenytoin to the protein constituents of the enteral formula, phenytoin binding to the calcium in the enteral formula, and inadequate dissolution of the suspension when delivered with the enteral formula due to the high pKa of phenytoin and the acidic nature of the enteral formula. We therefore evaluated the effects of pH levels 2.0, 3.5, 6.0, and 8.0 on the interaction of phenytoin suspension with enteral formula (Osmolite) with equilibrium dialysis using a Spectra/Por 1 (MWCO 6000–8000) molecularporous dialysis membrane. Phenytoin concentrations in the dialysis membrane (internal phase) mimicked the expected stomach concentrations of a 100‐mg dose administered in an adult stomach containing 200 ml of gastric fluid. External phase buffers were sampled at 0.5, 1.0, 2.0, 4.0, 8.0, 12.0, and 24.0 hr after the start of the dialysis. The phenytoin concentrations in the external phase were compared between buffer alone or buffer combined with enteral formula at the same pH and time intervals. With pH 2.0 and 3.5 the enteral formula formed an aggregate with suspension whereas no aggregate was formed with pH 6.0 and 8.0. The phenytoin concentrations with pH 2.0 were 26% to 44% lower and with pH 3.5 were 11.5 to 27% lower when phenytoin suspension was combined with enteral solution. However, at 24 hr there was no difference between the two conditions with both pH 2.0 and 3.5. With pH 6.0 there was a significant difference at 24 hr and with pH 8.0 significant differences were reached only at 0.5, 1.0 and 2.0 hr. These results show that the phenytoin suspension/enteral formula interaction is pH dependent. There appears to be a physical entrapment of the large suspension particles when the protein in the enteral solution denatures at lower pH's. These results may in part explain the decreased erratic absorption when phenytoin suspension is combined with enteral feedings. (Journal of Parenteral and Enteral Nutrition 14:275–278, 1990)