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Keywords: total parenteral nutrition
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Articles
Journal:
Clinical Science
Clin Sci (Lond) (1996) 91 (3): 371–374.
Published: 01 September 1996
...Mr S. M. Plusa; N. Webster; J. N. Primrose 1. Total parenteral nutrition is associated with a high incidence of septic complications. This may be partly due to neutrophil dysfunction induced by the parenteral nutrition. 2. Neutrophil adhesion molecule expression and the expression of CD11b in...
Abstract
1. Total parenteral nutrition is associated with a high incidence of septic complications. This may be partly due to neutrophil dysfunction induced by the parenteral nutrition. 2. Neutrophil adhesion molecule expression and the expression of CD11b in response to stimulation with formylmethionyl-leucyl-phenylalanine and lipopolysaccharide were determined before and after 24 h of lipid-containing parenteral nutrition. Eighteen adult patients referred for parenteral nutrition were studied. 3. There was no change in the expression of neutrophil l-selectin (CD62L), CD11a, CDllb, CD11c or CD15. Neutrophil response to stimulation with formylmethionyl-leucyl-phenylalanine and lipopolysaccharide as determined by CD11b expression was unaffected by parenteral nutrition. 4. This study has shown no evidence of parenteral nutrition-induced neutrophil dysfunction.
Articles
Kjell Malmlöf, Zuzana Cortova, Henri Saxerholt, Eivor Karlsson, Vibeke Arrhenius-Nyberg, Anna Skottner
Journal:
Clinical Science
Clin Sci (Lond) (1995) 88 (3): 285–292.
Published: 01 March 1995
... hormone (467.7 m-i.u. day −1 kg −1 ) for two post-operative days. Vehicle and peptides were infused intravenously together with total parenteral nutrition providing 129 kJ day −1 kg −1 non-protein calories and 0.35 gN day −1 kg −1 . 2. On both post-operative days the mean concentration of insulin-like...
Abstract
1. After surgery three groups of six female pigs weighing on average 52.2 kg (SD 3.5) received vehicle, recombinant insulin-like factor-1 (364.4 μg day −1 kg −1 ) or recombinant human growth hormone (467.7 m-i.u. day −1 kg −1 ) for two post-operative days. Vehicle and peptides were infused intravenously together with total parenteral nutrition providing 129 kJ day −1 kg −1 non-protein calories and 0.35 gN day −1 kg −1 . 2. On both post-operative days the mean concentration of insulin-like growth factor-1 in arterial blood samples was clearly below presurgical levels in animals receiving vehicle or recombinant human growth hormone, whereas recombinant human insulin-like growth factor-1 infusions more than restored insulin-like growth factor-1 concentrations. These last samples, however, contained significantly ( P <0.05) less insulin than those from other animals. 3. Infusion of recombinant human growth factor was often associated with higher circulating levels of amino acids compared with recombinant human insulin-like growth factor-1 infusions. Despite this, both hormones significantly ( P < 0.05) increased the hind limb net balance of total amino acids on postoperative day 1. Net balances of −44.2, +69.5 and +100.9 μmol/min (pooled SE 35.3) were associated with infusion of vehicle, recombinant human insulinlike growth factor-1 and recombinant human growth hormone respectively. This response was also closely reflected in the group of non-essential amino acids. 4. The net efflux of alanine from the hind limbs was also significantly ( P < 0.002) reduced, whereas glutamine was less affected. 5. On post-operative day 2, there was a general drop in cortisol and urea levels, implying a loss of catabolic tone. Concomitantly, most effects seen on amino acids flux after hormone administration on the previous day disappeared. 6. It is concluded that, in the acute catabolic state, both recombinant human insulin-like growth factor-1 and recombinant human growth hormone can prevent the erosion of body protein by increasing the peripheral net balance of amino acids and can thus increase the efficacy of total parenteral nutrition.
Articles
Toshikazu Yamanouchi, Susumu Minoda, Nobuyuki Ogata, Yumi Tachibana, Nori Sekino, Hideo Miyashita, IEO Akaoka
Journal:
Clinical Science
Clin Sci (Lond) (1995) 88 (2): 203–210.
Published: 01 February 1995
..., is mainly ingested in the diet and is excreted in urine. We compared the influence of the long-term administration of total parenteral nutrition free of 1,5-anhydroglucitol with that of total enteral nutrition on the serum level of 1,5-anhydro-D-glucitol in 46 patients who could not take food by...
Articles
Journal:
Clinical Science
Clin Sci (Lond) (1994) 86 (3): 339–345.
Published: 01 March 1994
... metabolism total parenteral nutrition tumour valine Clinical Science (1994) (16, 33W45 (Printed in Great Britain) 339 Tumour and host tissue responses to brancheckhain amino acid supplementation of patients with cancer M. A. McNURLANI, S. D. HEYS', K. G. M. PARK', J. BROOM), D. S. BROWN', 0. EREMIN...
Abstract
1 Rates of protein synthesis have been measured from the incorporation of 57 mg of l-[1- 13 C]leucine/kg for 90 min into muscle tissue and colorectal tumours removed at surgery from cancer patients. 2. For the 20 h preceding surgery and during the measurement of protein synthesis, the patients received intravenous saline, conventional intravenous nutrition (0.2 g of N and 103 non-protein kJ/kg body weight) or intravenous nutrition enriched with the branched-chain amino acids leucine, isoleucine and valine (0.2 g of N with 30% from branched-chain amino acids and 103 non-protein kJ/kg body weight). 3. Conventional intravenous nutrition resulted in a significant stimulation of the rate of protein synthesis in both muscle tissue (2.64 ± 0.75%/day versus 1.78 ± 0.51%/day in saline control, means ± SD) and tumour tissue (43.9 ± 10.3%/day versus 22.6 ± 5.6%/day in saline control). 4. Pre-operative nutrition enriched with branched-chain amino acids was less effective than conventional intravenous nutrition in stimulating protein synthesis in both muscle and tumour. The rates of protein synthesis were 2.12 ± 0.41%/day in muscle and 33.7 ± 5.3%/day in the tumours. 5. The expression of proliferating cell nuclear antigen in sections of the tumours showed changes with intravenous feeding of the two different amino acid mixtures that were similar to the changes in protein synthesis, and these two variables were significantly correlated. This is evidence that feeding with conventional mixtures and mixtures enriched with branched-chain amino acids stimulates tumour growth. 6. In this study the mixture enriched with branched-chain amino acids provided no clear advantage for cancer patients, since a smaller response to branched-chain amino acids was observed in both tumours and host muscle tissue.
Articles
Journal:
Clinical Science
Clin Sci (Lond) (1990) 78 (3): 273–281.
Published: 01 March 1990
... glucagon glycerol indirect calorimetry insulin metabolic regulation resting energy expenditure total parenteral nutrition urea Clinical Science (1990) 78,273-281 273 Effects of glucose on nitrogen balance during high nitrogen intake in malnourished, patients R. ARMOR FORSE", DAVID H. ELWYNt...
Abstract
1. The effects of increasing glucose intake on nitrogen balance, energy expenditure and fuel utilization were measured in 12 malnourished adult patients receiving parenteral nutrition with constant, very high nitrogen intake (500 mg of N/kg), high (105 kJ/kg) or low (30 kJ/kg) glucose intake and constant fat intake (7 kJ/kg). Each patient received each diet for 8-day periods in random order. 2. Energy balance and nitrogen balance were determined daily. Blood samples, taken at admission, during 5% (w/v) dextrose (D-glucose) infusion and at the end of days 7 and 8 of each diet, were analysed for urea, glucose, lactate, triacylglycerols, fatty acids, glycerol, 3-hydroxybutyrate, insulin and glucagon. 3. The effect of increasing glucose intake was to increase nitrogen balance by 0.60 ± 0.25 ( sem ) mg/kJ. At zero energy balance, nitrogen balance was 48 mg day −1 kg −1 . This confirms findings of previous studies: that the effects of glucose on nitrogen balance are greater at high than at low nitrogen intakes, and that, in malnourished patients, unlike in normal adults, markedly positive nitrogen balance can be achieved at zero or negative energy balances. 4. Changes in nitrogen balance were due almost entirely to changes in urea excretion. 5. The high nitrogen intake markedly increased plasma insulin and glucagon concentrations and reduced glycerol, fatty acid and 3-hydroxybutyrate concentrations, independent of any glucose effect. Glucagon concentrations were significantly decreased by added glucose intake, an effect not previously seen at low nitrogen intakes. At this high nitrogen intake, the effects of added glucose appear to be mediated by both insulin and glucagon. 6. Unlike the effects at low nitrogen intakes, added glucose caused no increase in energy expenditure (thermogenesis) or creatinine excretion, and almost no increase in glycogen stores.
Articles
James D. Albert, Dwight E. Matthews, Adrian Legaspi, Kevin J. Tracey, Malayappa Jeevanandam, Murray F. Brennan, Stephen F. Lowry
Journal:
Clinical Science
Clin Sci (Lond) (1989) 77 (1): 113–120.
Published: 01 July 1989
...-catabolic response under conditions of partial immobility induced by hospitalization. 4 5 1988 20 12 1988 © 1989 The Biochemical Society and the Medical Research Society 1989 amino acid flux arm exercise leg protein kinetics total parenteral nutrition Clinical Science (1989...
Abstract
1. The effect of a daily submaximal exercise regimen on whole-body and peripheral tissue amino acid metabolism during weight-stable intravenous feeding (IVF) was evaluated in 11 normal volunteers. Five of the subjects performed 1 h of daily bicycle exercise at 75 W during IVF, while the remaining six subjects received IVF without daily exercise. Body nitrogen balance, leg and forearm plasma amino acid flux and whole-body kinetics were measured before and on day 10 of IVF using a [1- 13 C]leucine and [ 15 N]glycine tracer. 2. At the end of the IVF period, exercised subjects demonstrated leg uptake of total amino acids (237 ± 103 nmol min −1 100 ml −1 of tissue, mean ± sem) which was significantly ( P < 0.05) different than in non-exercised subjects (− 1101 ± 253 nmol min −1 100 ml −1 of tissue). 3. In the non-exercised forearm, a significant ( P < 0.05) decrease in total amino acid flux was observed in exercised subjects (− 162 ± 88 nmol min −1 100 ml −1 of tissue) compared with non-exercised subjects (−460 ± 105 nmol min −1 100 ml −1 of tissue) on day 10 of IVF. 4. Efflux of 3-methylhistidine significantly ( P < 0.05) decreased from the leg in those subjects who performed daily exercise (−0.29 ± 0.12 nmol min −1 100 ml −1 of tissue) compared with those subjects receiving IVF without daily exercise (− 1.46 ± 0.35 nmol min −1 100 ml −1 of tissue). 5. Although IVF increased whole-body leucine turnover in both exercised and non-exercised subjects, only exercised subjects demonstrated a significant ( P < 0.05) increase in leucine oxidation which was proportionate to an increased muscle uptake of leucine. Whole-body protein breakdown, as assessed by [ 15 N]glycine, was significantly ( P < 0.05) decreased in exercised subjects compared with non-exercised subjects during IVF. 6. These data demonstrate that daily submaximal exercise produced a systemic as well as limb-specific enhancement of amino acid balance in muscle, providing an anti-catabolic response under conditions of partial immobility induced by hospitalization.
Articles
Journal:
Clinical Science
Clin Sci (Lond) (1989) 76 (6): 581–588.
Published: 01 June 1989
... Society and the Medical Research Society 1989 energy metabolism glucose utilization lipogenesis total parenteral nutrition Clinical Science (1989) 76, 581-588 581 Effect of replacing glucose with lipid on the energy metabolism of newborn infants J. E. E. VAN AERDE*, P. J. J. SAUERt, P. B...
Abstract
1. Indirect calorimetry and primed constant infusion of [U- 13 C]glucose were combined in 28 appropriate-for-gestational age newborn, parenterally fed infants, in order to measure glucose utilization and glucose oxidation and to estimate lipogenesis from glucose. 2. The infants were randomly allocated to either a group receiving glucose as the non-protein energy source or a group having one-quarter of the glucose energy replaced by intravenous fat. The energy intake (370 kJ day −1 kg −1 ) and protein intake (3.4 g day −1 kg −1 ) were similar in both groups. 3. Energy expenditure ( P < 0.005), non-protein carbon dioxide production ( P < 0.005) and non-protein oxygen consumption ( P < 0.05) were lower in the lipid-supple-mented group. 4. The significant excess of glucose utilization over oxidation ( P < 0.001) can be accounted for by lipid synthesis from glucose. 5. Fat synthesis from glucose was higher in the glucose/amino acid group ( P < 0.02), but total fat storage was higher in the lipid-supplemented group ( P < 0.02). Nitrogen balance was similar in both groups. 6. As lipogenesis from glucose is an energy- and oxygen-consuming and a carbon dioxide-producing process, the data suggest that the differences between the glucose-only group and the lipid-supplemented group are due to different rates of lipogenesis from glucose.
Articles
Journal:
Clinical Science
Clin Sci (Lond) (1989) 76 (6): 595–598.
Published: 01 June 1989
... decarboxylase polyamines proliferation total parenteral nutrition urogastrone Clinical Science (1989) 76,595-598 595 Is polyamine synthesis involved in the proliferative response of the intestinal epithelium to urogastrone-epidermal growth factor? R. A. GOODLAD, H. GREGORY* AND N. A. WRIGHT Cancer...
Abstract
1. Intestinal epithelial cell proliferation was measured in rats maintained on total parenteral nutriton (TPN), in TPN rats given 300 μg of recombinant human epidermal growth factor (urogastrone-epidermal growth factor, URO-EGF) day −1 kg −1 , and in further groups given URO-EGF and difluoromethylornithine (DFMO), an inhibitor of the enzyme ornithine decarboxylase (ODC). 2. URO-EGF significantly increased intestinal cell proliferation throughout the gastrointestinal tract. The proliferative response of the colon was particularly pronounced. 3. DFMO reduced the proliferative effect of urogastrone in the stomach and small intestine. DFMO also reduced URO-EGF-stimulated intestinal cell proliferation in the colon, but to a lesser extent. 4. It is concluded that ODC is essential for effecting the proliferative response of the stomach and small intestine to URO-EGF, but this role may be less important in the colon.
Articles
Journal:
Clinical Science
Clin Sci (Lond) (1988) 75 (2): 121–126.
Published: 01 August 1988
...) on the gastrointestinal epithelium. 2. The response of the gastrointestinal tract to URO-EGF was investigated in rats maintained on total parenteral nutrition (TPN) with or without 75% small bowel resection. 3. Continuous infusion of 60 μg of recombinant β-urogastrone/day per rat increased...
Abstract
1. The objective of this study was to see whether another proliferative stimulus could modify the marked proliferative effect of human epidermal growth factor (urogastrone-epidermal growth factor, URO-EGF) on the gastrointestinal epithelium. 2. The response of the gastrointestinal tract to URO-EGF was investigated in rats maintained on total parenteral nutrition (TPN) with or without 75% small bowel resection. 3. Continuous infusion of 60 μg of recombinant β-urogastrone/day per rat increased proliferation in the stomach by over four times ( P < 0.01), doubled proliferation in the small intestine ( P < 0.001) and increased it by four and a half times in the colon ( P < 0.001) in the control group. No significant effect of urogastrone was observed in the stomach of the resected groups, but proliferation was also increased in the small intestine by one and a half times ( P < 0.001) and by nearly four times in the colon ( P < 0.001). 4. Two-way analysis of variance showed that resection had a significant effect ( P < 0.01) on proliferation below the anastamosis and in the ileum. However, the response of the ileum was only half that observed in orally fed rats, which confirms the importance of ‘luminal nutrition’ in the response to resection. 5. Intestinal resection in the TPN rat was associated with a small rise in plasma enteroglucagon levels, suggesting that this hormone may be implicated in the adaptive response of the small intestine to resection. However, the proliferative effects of URO-EGF were not associated with increased plasma enteroglucagon and thus the two agents probably exert their proliferative effects via separate mechanisms. 6. There was no evidence for a significant positive interaction between the effects of URO-EGF and resection. Thus loss of intestinal mass had no influence on the susceptibility of the intestine to the effects of URO-EGF. Although URO-EGF significantly increased intestinal epithelial cell proliferation, it could not entirely compensate for the lack of luminal contents.
Articles
Journal:
Clinical Science
Clin Sci (Lond) (1986) 70 (6): 587–593.
Published: 01 June 1986
... lipogenesis. 28 11 1985 24 1 1986 © 1986 The Biochemical Society and the Medical Research Society 1986 glucose indirect calorimetry lipogenesis total parenteral nutrition ClinicalScience(1986) 70 , 587-593 587 Glucose oxidation rates in newborn infants measured with indirect...
Abstract
1. Indirect calorimetry and primed constant infusion of [U- 13 C]glucose were combined in 16 appropriate-for-gestational age newborn, parenterally fed infants, in order to measure glucose utilization and glucose oxidation respectively. 2. Glucose intake ranged between 10.0 and 24.1 g day −1 kg −1 and energy intake between 156.9 and 439.3 kJ day −1 kg −1 . 3. Glucose utilization ( P < 0.001), glucose oxidation ( P < 0.001) and metabolic rate ( P < 0.005) increased significantly with rising glucose intake. 4. The significant difference between glucose utilization and oxidation ( P < 0.001) can be accounted for by an increasing storage as fat. 5. As lipogenesis from glucose consumes 15-24% of the original glucose energy, the increasing metabolic rate accompanying rising glucose intake is probably due to increasing lipogenesis.
Articles
Journal:
Clinical Science
Clin Sci (Lond) (1980) 59 (5): 317–327.
Published: 01 November 1980
...C. A. Hughes; R. H. Dowling 1. To establish the speed of onset of jejunal and ileal mucosal hypoplasia and hypofunction in parenterally fed rats, we measured three indices of mucosal mass, three mucosal enzymes and quantitative histology after 3, 6, 10 and 15 days of total parenteral nutrition and...
Abstract
1. To establish the speed of onset of jejunal and ileal mucosal hypoplasia and hypofunction in parenterally fed rats, we measured three indices of mucosal mass, three mucosal enzymes and quantitative histology after 3, 6, 10 and 15 days of total parenteral nutrition and compared the results with those in two orally fed control groups, one with and one without intravenous catheters and metabolic cage restraint. The kinetics of galactose absorption in vivo were also measured after 10 days of total parenteral nutrition and in both control groups. 2. The most striking decrease in both jejunal and ileal mucosal wet weight and protein and DNA content per 10 cm length of intestine, occurred after only 3 days of total parenteral nutrition; thereafter the mean values showed only a slight further decrease. 3. The results of the morphometric studies showed that the hypoplasia affected the villi slightly more than the crypts. Within 3 days of starting total parenteral nutrition, mean jejunal mucosal thickness decreased by 16% and after 15 days it had fallen by 28%. The ileum showed similar, although less marked, changes. In the jejunum (not the ileum) modest cellular hypotrophy accompanied the mucosal hypoplasia; there were more epithelial cells/unit length of mid-villus and there was more DNA per g of mucosa in the total parenteral nutrition group than in the control group of rats. 4. Jejunal galactose absorption from the 16, 32 and 64 mmol/l solutions was significantly less in the 10-day total parenteral nutrition rats than in the controls, the apparent V max being five times greater in the orally fed animals. The apparent Michaelis constant ( K m ) was also significantly less than normal in the jejunum of the parenterally fed rats, suggesting increased affinity of the hypothetical carrier for galactose, perhaps as a result of functionally hypermature cells. 5. Mucosal alkaline phosphatase and catalase activities per unit length of intestine decreased and α-d-glucosidase activity increased in the jejunum and ileum of the total parenteral nutrition rats. 6. These results show that during total parenteral nutrition, the ileum and particularly the jejunum show marked reductions in mucosal mass and function after only 3 days of total parenteral nutrition and that there is a more gradual and progressive loss of mucosal mass thereafter up to 15 days.