bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determination of Plasma‐Free Fatty Acid Kinetics with Tracers: Methodologic Considerations
Authors: Miles J.M. , Jensen M.D. 
Published: May 2008

Plasma‐free fatty acids (FFA) are an important source of energy for a variety of tissues. Recently, there has been an increased interest in the measurement of FFA kinetics in vivo, using radiolabeled or stable isotopic tracers.Standard techniques for measurement of FFA‐specific activity are relatively imprecise and have limited sensitivity. We have developed a method for determination of the concentration and specific activity of individual plasma FFA that is precise (coefficient of variation <2%) and sensitive (detection limit in the high femptomolar to low picomolar range). Using this method, one can measure the kinetics of three or more long‐chain fatty acids simultaneously. Its sensitivity is a particular advantage if one wishes to measure low rates of FFA turnover such as are encountered during hyperinsulinemia.It has been suggested that, for optimal accuracy in the determination of substrate kinetics, the tracer should be administered in the left ventricle and mixed venous blood samples should be obtained from the right heart. We have conducted experiments in dogs which demonstrate that peripheral tracer infusion and more conventional arterial (or arterialized venous) sampling actually provide more accurate estimates of FFA turnover; this is fortunate, since intracardiac infusion and sampling are not practical for human studies. (Journal of Parenteral and Enteral Nutrition 15:90S‐92S, 1991)
Tunneled Central Venous Catheter Sepsis: Risk Factors in a Pediatric Hospital
Authors: Mulloy R.H. , Jadavji T. , Russell M.L. 
Published: May 2008

All tunnelled central venous catheters (TCVC) placed at the Alberta Children's Hospital in Calgary, Alberta, between November 1984 and July 1987, were retrospectively reviewed to study the association of catheter infection with a number of factors including age, diagnosis, catheter use, and areas caring for children.One hundred children received 130 silastic catheters placed for a total of 17,861 days. Each catheter survived a median of 100 days. Thirty‐one episodes of catheter sepsis were identified (one episode for each 576 days of catheter use). Children under 2 years of age had more than two times the risk of catheter infection (p < 0.01). Children with malabsorption had a greater risk (45.7%) than did those with infection (25.0%) or cancer (15.5%). The use of catheters for total parenteral nutrition (TPN) or for multiple purposes markedly increased the risk of catheter infection.The risk of infection of TCVC appears to be great in the young child, in particular, in those requiring TPN or multiple intravenous infusions. Use of TCVC in these children should be avoided if possible. (Journal of Parenteral and Enteral Nutrition 15: 460–463, 1991)
The Relationship Between Enteral Formula Contamination and Length of Enteral Delivery Set Usage
Authors: Kohn Carol L. 
Published: May 2008

Twenty‐one delivery sets were collected from 21 patients who had received continuous Osmolite feedings over 24 hours. Delivery sets were then taken to the laboratory and hung for an additional 48 hours. In the laboratory, the delivery sets were rinsed with tap water and Osmolite was added every 12 hours. Formula samples were obtained from the delivery sets after they had been used for 24 hours, and every 12 hours during the additional 48 hours in the laboratory. Formula contamination was assessed by determining bacterial counts. Unacceptable contamination was defined as bacterial counts ≥ 105 cfu/mL.The mean bacterial count was 2.8 × 105 cfu/mL at 24 hours, and all subsequent mean counts increased over time. There were statistically significant differences among the mean log bacterial counts at all time periods (p ≤ 0.0005) except between 36 hours and 48 hours (p = 0.019). Of the 21 delivery sets, 23.8% were unacceptably contaminated at 24 hours, and by 48 hours, 42.9% were unacceptable. These findings suggest that if 105 cfu/mL is used as a criterion, delivery sets should not be used for more than 24 hours in a hospital, and 24‐hour use of delivery sets may even be too long. (Journal of Parenteral and Enteral Nutrition 15:567–571, 1991)
Composition of Fat in Enteral Diets Can Influence Outcome in Experimental Peritonitis M. D. PECK, C. K. OGLE, J. W. ALEXANDER Annals of Surgery 214:74–82, 1991
Authors: Sax Harry 
Published: May 2008

The potential immunosuppressive effects of lipids high in the n‐6 polyunsaturated fatty acids (PUFA) have led many clinicians to recommend limiting fat intake in stressed patients. Similarly, experimental and clinical evidence has been presented that supports the use of lipid formulations enriched in the marine‐based n‐3 PUFA in these patients.1,2This paper describes an experimental study designed to address the effect of dietary fat composition on outcome in an animal model of chronic intra‐abdominal sepsis. Guinea pigs underwent gastrostomies and were later implanted with osmotic pumps inoculated with a mixture of Escherichia coli and Staphylococcus aureus. A steady infusion of this synergistic combination of bacteria into the peritoneal cavity resulted in an animal model of chronic intra‐abdominal sepsis. Animals were randomized to one of three dietary groups according to the level of fat intake: 3.5%, 14%, and 56% of total calories. Within each of these groups, fat composition was either high in n‐6 PUFA (100% Microlipid), high in n‐3 PUFA (100% maximum eicosapentaenoic acid [MaxEPA]) or a 50:50 mixture of the two.Animal survival was not significantly altered by the amount of fat in the diet (Kruskal‐Wallis analysis of variance, p >.1). However, the dietary fat composition had a significant overall effect (p <.05) on the length of survival. Median survival in the 50:50 group was 12.5 days, significantly longer than that in the 100% MaxEPA group (9 days), p =.011), but not significantly longer than that in the 100% Microlipid group (10 days, p =.082).In another experiment animals were fed a 14% total fat calorie diet. A total of five subgroups were created, with fat ratios (Microlipid/MaxEPA) of 100/0, 25/75, 50/50, 75/25, and 0/100. Survival was greatest in the group of animals given equal amounts of fat types: 18%, 25%, 84%, 42%, and 36% (p =.023, 50:50 group vs all other groups).No major differences in immunologic parameters among the various groups were noted, except for an increase in lipopolysaccharide‐stimulated prostaglandin E2 production by splenic macrophages in the 100% Microlipid group (p =.03).
Jejunal Mucosal Injury and Restitution: Role of Hydrolytic Products of Food Digestion P. R. KVIETYS, R. D. SPECIAN, M. B. GRISHAM, AND P. TSO American Journal of Physiology 24:G384‐G391, 1991
Authors: Demetriou Achilles A. 
Published: May 2008

The authors examined the effects of hydrolytic products of carbohydrate, protein, and lipid digestion on jejunal injury and restitution in anesthetized rats. Mucosal epithelial integrity was assessed by measuring blood‐to‐lumen clearance of 51Cr‐labeled EDTA administered as a bolus into the femoral vein. When the intestinal lumen was perfused with 3% hydrolyzed casein or 150 mmol/L glucose there was no effect on 51Cr‐EDTA clearance when compared with saline controls. However, perfusion with emulsified lipids (20 mmol/L sodium taurocholate and 10 to 40 mmol/L oleic acid) resulted in a statistically significant (p <.05) increase in 51Cr‐EDTA clearance in a dose‐dependent fashion. When lipid infusion was terminated and saline perfusion resumed, 51Cr‐EDTA clearance returned to control levels.Histologic examination of the jejunal mucosa revealed damage of the epithelial lining of the villous tips in animals treated with lipid infusion. The injury was characterized by gaps in the epithelial lining of the villous tips and the presence of exfoliated cells in the mucous layer overlying the disrupted epithelium. After termination of the lipid infusion, epithelial integrity was reestablished within 50 minutes. Nearly 50% of the villi show a discontinuous epithelium at their tips immediately after lipid perfusion is terminated. Subsequent perfusion with saline results in partial restitution with only 14% of the villi affected 30 minutes and 2.6% 50 minutes later.In vitro studies using monolayer cultures of a rat intestinal epithelial cell line (IEC‐18) demonstrated that neither glucose nor hydrolyzed casein had a deleterious effect on cell integrity. However, oleic acid emulsified in rat hepatic bile produced a dose‐dependent disruption of the epithelial cell monolayer when added to the cultures.Biochemical determinations of lipid peroxidation products both in vivo and in vitro did not reveal any significant differences among the various groups, suggesting that the lipid‐induced injury was not due to lipid peroxidation.The authors conclude that because the concentrations of the various nutrients used in the present study are similar to those found in postprandial chyme, their findings suggest that intestinal epithelial injury and restitution take place during the course of digestion and absorption of a meal.
Gastroesophageal Reflux in Intubated Patients Receiving Enteral Nutrition: Effect of Supine and Semirecumbent Positions
Authors: Ibáñez Jordi , Peñafiel Albert , Raurich Joan María , Marse Pere , Jordá Ricard , Mata Felix 
Published: May 2008

The incidence of gastroesophageal reflux (GER) in critically ill patients as well as the effect of a nasogastric tube (NGT) and body position as risk factors for GER were determined. Seventy patients with orotracheal intubation receiving enteral nutrition through a NGT for more than 48 hours were prospectively studied with two randomly assigned body positions: supine or semirecumbent. Detection of GER was achieved by scintigraphy after labeling gastric contents with 500 μCi of technetium‐99m sulfur colloid administered through the NGT. In 50 patients scintigraphy was performed after subjects had remained in the randomized position for 2 hours with the NGT pinched. Twenty additional patients were studied after the NGT had been removed.In 50 patients with NGT, GER was present in 74% (37 of 50) and was higher in the supine position (81%, 21 of 26) than in the semirecumbent position (67%, 16 of 24), but this difference was not statistically significant (p =.26). In 20 patients without NGT, the incidence of GER was 35% (7 of 20) and it was also higher in the supine (50%, 6 of 12) than in the semirecumbent position (12%, 1 of 8, p =.16). There was a statistically significant difference between GER in patients with and without NGT (74% vs 35%, p =.0002). These data show that there is a high incidence of GER in patients with orotracheal intubation and NGT. The presence of a NGT is a risk factor for GER. Semirecumbency does not prevent GER, but there is less incidence than in the supine position. (Journal of Parenteral and Enteral Nutrition 16:419–422, 1992)
Polymyxin B Reduces Total Parenteral Nutrition‐Associated Hepatic Steatosis by Its Antibacterial Activity and by Blocking Deleterious Effects of Lipopolysaccharide
Authors: Pappo Itzhak , Bercovier Herve , Berry Elliot M. , Haviv Yosef , Gallily Ruth , Freund Herbert R. 
Published: May 2008

Overgrowth of Gram‐negative bacteria as a result of total parenteral nutrition (TPN) and bowel rest could be responsible for the release of a variety of hepatotoxic substances such as endotoxin or tumor necrosis factor (TNF) and the ensuing TPN‐associated liver function derangements. Polymyxin B is an effective antimicrobial agent as well as a blocking agent for endotoxin (lipopolysaccharide) activity and TNF production. In the present study we compared the oral and intravenous effects of polymyxin in rats receiving TPN in an attempt to define these two possible mechanisms of action of polymyxin on TPN‐associated hepatic steatosis.Both oral, as well as intravenous polymyxin B, significantly reduced total hepatic fat and triglyceride accumulation in TPN rats, more so in the intravenous group exhibiting close to control levels. Both polymyxin‐treated groups exhibited significantly lower Gram‐negative bacterial counts in the cecum, with the oral group exhibiting a lower count than the IV group. The spontaneous production of TNF by peritoneal macrophages was markedly increased in rats receiving TPN and very close to being undetected in both groups receiving TPN and polymyxin.We believe polymyxin B protects the liver during TPN by both its antimicrobial effect which prevents overgrowth of gut Gram‐negative bacteria and the subsequent translocation of endotoxin, and by its specific antilipopolysaccharide activity which, in the present study, completely abolished hepatic steatosis and TNF production during TPN. (Journal of Parenteral and Enteral Nutrition 16:529–532, 1992)
Nutritional Outcome and Pneumonia in Critical Care Patients Randomized to Gastric versus Jejunal Tube Feedings M. A. MONTECALVO, K. A. STEGER, H. W. FARBER, ET AL Critical Care Medicine 20:1377–1387, 1992
Authors: Demetriou Achilles A. 
Published: May 2008

A prospective study was carried out over a 10‐month period to compare nutritional status, gastric colonization, and rates of nosocomial pneumonia in intensive care unit (ICU) patients randomized to either gastric tube feeding or feeding by an endoscopically placed jejunal tube. Sixty‐nine patients were considered eligible for the study. Thirty‐eight patients were enrolled from medical and surgical ICUs at two hospitals and were equally divided into two groups. The groups were similar in age, sex, race, underlying disease, type of surgical procedure, number of days fed, duration of ICU stay, duration of mechanical ventilation, days with fever, and days of antibiotic therapy. The jejunal tube (JT) group had more patients who were in circulatory shock on admission (79%) than the gastric feeding (GT) group (68.4%). Additionally, the JT group had higher Acute Physiology Scores (24.0 vs 21.7) and fewer patients with pneumonia at the time of entry into the study (26.3% us 31.6%). The JT patients received a significantly higher percentage of their daily goal caloric intake (p <.05) and had a significantly greater increase in serum prealbumin concentration (p <.05) than the GT patients. The difference in incidence of diarrhea between the two groups was not statistically significant (JT: 3.3 ± 6.6 days; GT: 1.8 ± 2.9 days). Two patients in the GT group (10.5%) and none in the JT group developed nosocomial pneumonia. In a subset of 12 patients from both groups (JT: n = 5; GT: n = 7), quantitative cultures of the pharynx, stomach, and sputum were carried out. No significant differences in the median levels of colonization with Gram‐negative bacilli were seen between the two groups (at each site); similarly, the numbers of Gram‐positive cocci and Candida species for the two groups were similar at all sites.The authors concluded that patients fed by JT received a significantly higher proportion of their daily caloric intake, had a significantly greater increase in serum prealbumin concentrations, and had a lower rate of pneumonia than patients fed by continuous GT.
Arginine Stimulates Wound Healing and Immune Function in Elderly Human Beings
Authors: Nussbaum Michael S. 
Published: May 2008

This prospective randomized trial evaluated the effect of oral supplements of arginine aspartate on wound healing and immune responses in healthy elderly (over 65 years old) volunteers. This laboratory previously demonstrated that arginine supplementation enhances wound‐breaking strength, reparative collagen synthesis, and T‐cell‐mediated immune function in healthy animals and human beings,1,2 whereas immune suppression associated with trauma is abrogated.3 Thirty subjects received daily supplements of 30 g of arginine aspartate (17 g of free arginine) and 15 individuals received placebo syrup for a 14‐day course. Wound healing was evaluated by two methods: (1) fibroplasia was measured by using subcutaneously implanted polytetrafluoroethylene catheters for the determination of collagen deposition, total protein, and DNA content, and (2) rate of wound epithelialization was assessed by using a standard partial‐thickness wound. Lymphocyte blastogenesis was measured in a microculture system by using mitogenic stimulation with standard mitogens as well as alloantigens in a mixed lymphocyte response with stimulator cells collected from pooled healthy human donors. Serum insulin‐like growth factor‐1 (IGF‐1) was determined by radioimmunoassay.Arginine supplementation enhanced wound fibroplasia as evidenced by an increase in the amount of collagen deposition and total protein content. However, DNA content and time to complete epithelialization were equivalent in both groups. The blastogenic response of peripheral blood lymphocytes to all mitogens and alloantigens was significantly enhanced in the arginine‐supplemented group. Serum IGF‐1 levels were also significantly elevated in the arginine group.
Alterations in Intestinal Barrier Function Do Not Predispose to Translocation of Enteric Bacteria in Gastroenterologic Patients CJ O'Boyle, J Macfie, K Dave, et al Nutrition 14:358–362, 1998
Authors: Buchman Alan L. 
Published: May 2008

In this provocative study the authors investigated whether intestinal permeability in preoperative patients correlated with changes in small intestinal histology and permeability. Forty‐three patients (18 M, 25 F) aged 24 to 89 years (mean, 65 years) were studied. All patients were awaiting major abdominal surgery for the following diseases: colorectal cancer (n = 15), pancreatic cancer (n = 5), gastric cancer (n = 4), Crohn's disease (n = 4), ulcerative colitis (n = 3), diverticular disease (n = 3), and other (n = 9). No patient required total parenteral nutrition (TPN) or enteral nutrition support. “Subacute” obstruction was present in 18 patients (gastric outlet, intestinal, or colonic). Bacterial translocation was assessed by culture of a serosal biopsy taken from the antimesenteric border of the terminal ileum upon entering the abdomen and of a lymph node taken from the distal ileal mesentery. A simultaneous peripheral blood culture was taken. Histologic examination was performed on bowel removed from those patients who required small intestinal enterectomy. The villus height—total mucosal thickness ratio was measured using a measuring eyepiece on a light microscope. Intestinal permeability was measured 24 to 48 hours before surgery using the urinary lactulose (L)‐rhamnose (R) excretion ratio. Subjects ingested L‐rhamnose, 1 g, and lactulose, 5 g, and urine was collected for 5 hours.Bacteria were cultured from the excised lymph node in 9 (20.9%) patients. Seven of nine of the organisms were Gram‐negative intestinal flora, and the other two Gram‐positive species were also intestinal flora. Three of these patients developed postoperative wound infections compared with one of the other 34 patients, although none became septic. Intestinal permeability was increased in 21 patients (L‐R ratio> 0.05, n = 21), primarily on the basis of a significant increase in lactulose absorption. Bacterial translocation occurred in 5 (22.7%) of 22 patients with normal permeability and in 4 (19.0%) of 21 patients with increased permeability (p =.77). Data on villus height were not reported, but the villus height‐total mucosal thickness ratio was similar in patients with and without bacterial translocation (0.55 ± 0.14 vs 0.62 ± 0.11).
Unintentional poisoning by phosphine released from aluminum phosphide
Authors: Shadnia S , Mehrpour O , Abdollahi M 
Published: May 2008

Aluminum phosphide as a releaser of phosphine gas is used as a grain preservative. In this case report, we describe an accidental severe poisoning in a 35-year-old woman, her 18-year-old daughter, and 6-year-old son caused by inhalation of phosphine gas released from 20 tablets of aluminum phosphide stored in 15 rice bags. The boy died 2 days after exposure before admission to hospital and any special treatment, but the others were admitted 48 h after exposure. They had signs and symptoms of severe toxicity, and their clinical course included metabolic acidosis, electrocardiographic changes, and hypotension. They were treated by intravenous administration of sodium bicarbonate, magnesium sulfate, and calcium gluconate. The patients were discharged after 3 days and followed up for 1 week after discharge. Rapid absorption of phosphine by inhalation, induction of hyperglycemia, and surviving of patients are interesting issues of this case report.
Long-term exposure to gaseous formaldehyde promotes allergen-specific IgE-mediated immune responses in a murine model
Authors: Gu YH , Fujimiya Y , Kunugita N 
Published: May 2008

It has long been questioned that whether exposure to formaldehyde in indoor environments may be a risk factor for developing allergen-specific IgE-mediated inflammatory responses, because there is limited clinical or experimental evidence that formaldehyde is involved in the cascade for IgE production. There is no known lower limit, below which there is no threat of serious allergic symptoms. The present study illustrates that the threshold limit of formaldehyde, 0.08 ppm (as defined by the World Health Organization), did not cause ovalbumin-specific IgE inflammatory immune responses, but higher than threshold concentrations of formaldehyde gas result in both enhanced allergen-specific IgE responses and NK (Natural Killer)-cell activity in peripheral blood cells in a murine model. Thus, formaldehyde gas may be involved in promoting allergic inflammatory effects in subjects primed with specific allergens by NK-cell activation. These results indicate that even threshold concentrations of formaldehyde gas may play a regulatory role for ‘systemic’ cell-mediated immune responses. The extensive use of adhesives for building materials has resulted in higher levels of indoor air pollutants. It is conceivable that increased time indoors may enhance pre-existing allergic symptoms by concomitant exposure to volatile organic compounds and formaldehyde. The affordable limit for formaldehyde might be much lower than currently established levels in indoor environments.
Molecular profiling of LGL leukemia reveals role of sphingolipid signaling in survival of cytotoxic lymphocytes
Authors: Shah Mithun Vinod , Zhang Ranran , Irby Rosalyn , Kothapalli Ravi , Liu Xin , Arrington Ty , Frank Bryan , Lee Norman H. , Loughran Thomas P. 
Published: May 2008

AbstractT-cell large granular lymphocyte (LGL) leukemia is characterized by clonal expansion of CD3+CD8+ cells. Leukemic LGLs correspond to terminally differentiated effector-memory cytotoxic T lymphocytes (CTLs) that escape Fas-mediated activation-induced cell death (AICD) in vivo. The gene expression signature of peripheral blood mononuclear cells from 30 LGL leukemia patients showed profound dysregulation of expression of apoptotic genes and suggested uncoupling of activation and apoptotic pathways as a mechanism for failure of AICD in leukemic LGLs. Pathway-based microarray analysis indicated that balance of proapoptotic and antiapoptotic sphingolipid-mediated signaling was deregulated in leukemic LGLs. We further investigated sphingolipid pathways and found that acid ceramidase was constitutively overexpressed in leukemic LGLs and that its inhibition induced apoptosis of leukemic LGLs. We also showed that S1P5 is the predominant S1P receptor in leukemic LGLs, whereas S1P1 is down-regulated. FTY720, a functional antagonist of S1P-mediated signaling, induced apoptosis in leukemic LGLs and also sensitized leukemic LGLs to Fas-mediated death. Collectively, these results show a role for sphingolipid-mediated signaling as a mechanism for long-term survival of CTLs. Therapeutic targeting of this pathway, such as use of FTY720, may have efficacy in LGL leukemia.