Search

This study determines the effects of taurine (Tau) on phagocytosis of polymorphonuclear neutrophils (PMN) isolated from normal subjects (n = 41) and severely burned patients (n = 20). Phagocytosis was measured by nitroblue of tetrazolium (NBT) reduction in samples with and without latex bead stimulation. Taurine was added at doses of 0.2, 0.4, 0.8 and 1.6 mM to stimulated samples. In control cells there were statistically significant increases in phagocytosis after addition of Tau 0.8 mM and 1.6 mM to as compared to samples without Tau addition (295 ± 23% and 330 ± 35% vs. 248 ± 18%; mean ± S.E.; p < 0.05). A statistically significant increase in phagocytosis was observed in cells from the burned population after addition of Tau 1.6 mM (288 ± 38% vs. 198 ± 13%; mean ± S.E.; p < 0.05). No changes in phagocytosis were found in cells from a subgroup of burn patients (n = 13) followed over 7, 15 and 21 days. These results indicate that taurine supplementation in vitro at doses of 0.8 to 1.6 mM improves the phagocytic capacity of neutrophils in healthy subjects and in patients with severe burn injury, mainly when neutrophil function is unaltered.

Total antioxidant capacity (TAC) was measured after severe burns (non-electric with one exception) in two groups of patients: group A, 24 subjects (19 men and five women) 20-67 years old and group B, eight subjects (six men and two women) 20-54 years old, admitted to the Major Burns Unit of hospital general Vall d'Hebron over a period of nine months. Albumin, uric acid and antioxidant capacity analyses were carried out within 24 hours after injury in both groups, and additionally at 1, 7, 15 and 21 days in group B. Total antioxidant capacity was measured by inhibition of blue-green colour of the ABTS+ cation (600 nm) and compared with reference values obtained in healthy, sex and age-matched volunteers (n = 50). Results showed statistically increased mean antioxidant capacity values at 24 hours (Group A: 1.36 +/- 0.22 mmol/L; Group B: 1.66 +/- 0.39) as compared with reference values (range, 1.0 to 1.44 mmol/L), representing 42% of patients in group A and 50% in group B (overall mean 46%), with no correlation with severity of the burn. The longitudinal study (Group B) showed no correlation between total antioxidant capacity values and time (r = -0.171; ns). A statistically significant correlation was found between albumin and time (r = 0.438; p0.05), indicating a clear tendency toward normalisation of plasma albumin values during healing. There was no correlation among total antioxidant capacity, percentage of burned surface and clinical evolution, suggesting a poor sensitivity of the method for the study of this pathology.

Background : Short-bowel syndrome is a state of severe malabsorption resulting from absence or removal of the small bowel for several causes. A number of short-bowel patients develop hyperphagia. Leptin, a protein secreted from adipose tissue, signals the amount of energy stores to the brain. Objective : To study body composition and leptin regulation in short-bowel patients and to determine whether or not leptin concentrations are linked with hyperphagia. Design : We studied 25 short-bowel patients (remnant bowel less than 150 cm) and 31 controls and 10 oral nutrition. Fifteen patients received total parenteral nutrition and 10 oral nutrition. Anthropometric measurements, body composition (by bioelectrical impedance), and cholesterol, triacylglycerol and leptin concentrations were studied in all subjects. Results : There were no differences between short-bowel patients and controls in anthropometric variables, body composition, or leptin concentrations. Leptin concentrations were higher in short-bowel women than men (9.21±8.54 vs. 3.22±1.86 ng/ml, P =0.01). Leptin concentrations correlated positively with age (r=0.4, P =0.045), body mass index (r=0.52, P =0.007), fat mass (r=0.67, P =0.001) and body fat (r=0.68, P =0.0001); there were no correlations with other body composition parameters. We found no correlations between parenteral or oral nutrition and body composition parameters, or between leptin concentrations and the presence of hyperphagia. Logistic regression analysis showed that body fat correctly identified leptin concentrations in 60% of patients. Conclusions : Body composition, leptin concentrations and leptin regulation in patients with short-bowel syndrome are similar to those of controls. Leptin concentrations do not correlate with hyperphagia in short bowel-patients.

The effect of melatonin on inhibition of cell growth was studied in CT-26, a murine colon carcinoma-derived cell line. Cells growing in exponential phase were exposed to low (10(-7)-10(-10) M) and high doses (1, 2 and 3 x 10(-3) M) of melatonin during 24 h. Synthesis of DNA was measured by 5-bromo-2'-deoxyuridine incorporation. There was no effect at low doses, but a statistically significant correlation was found between the decrease in DNA synthesis and the dose of melatonin used (r = -0.52, P < 0.001). This implied the following percentages of inhibition: 1 mM, 22%; 2 mM, 25%; 3 mM, 47%. Potential cell membrane damage by high doses of melatonin was investigated by lactate dehydrogenase measurement and no significant levels were observed. Analysis with a single saturation technique showed no detectable oestradiol receptors in this cell type; therefore, we can assume that the effects occurring with the addition of melatonin were not mediated by modulation of this hormone on oestrogen receptors. The decreases in cell growth were attributed to a moderate, but significant antiproliferative action of melatonin on this non-hormone-dependent cell line.

The effects of oral fish oil (FO) supplementation (8 g/day, capsules) on nutritional status and selected immune markers (CD4/CD8 ratio, IL-1beta, erythrocyte MDA release, dehydroepiandrosterone sulfate [DHEA-S]) were studied in a homogeneous group of asymptomatic HIV-infected patients during 6 weeks. All subjects were classified clinically as A2 according to the CDC revised criteria (mean CD4 count 290 +/-123 cells/mm(3)) and were receiving zidovudine retroviral treatment. The calculated mean energy intake was 3437 +/- 372 Kcal/d, composed of 14% protein, 38% lipids and 48% carbohydrates, and was not modified during the study. The anthropometric parameters, and hematological and plasma biochemistry data showed non-significant changes after FO supplementation. Mean malonyldialdehyde (MDA) release before treatment was: unstimulated 71.5 +/- 37 and stimulated 350.9 +/- 79.8 nmol/g Hb. After FO supplementation (T(6)) MDA release showed unstimulated values of 96.1 +/- 62, and a significant increase after stimulation of 614.1 106.4 nmol/g Hb, which was, however, within the normal range. In the patient's samples, IL-1beta levels in the unstimulated blood culture showed a statistical increase with respect to the normal range before (T(0)) and after (T(6)) FO supplementation with a slight decrease after (mean 49.8 vs 40.9 pg/ml). The stimulated IL-1beta levels after treatment showed a statistically significant decrease that was maintained within the normal range (T(0): 797.7 vs T(6): 535.6 pg/ml). Taken collectively, these results suggest a tendency toward improvement in immune function.

ummary A study was designed to measure the body surface area of Spraguc-Dawley rats and to compare the results with those obtained using the mathematical formulas described by four authors to estimate this parameter. The animals were killed by an overdose of ether anaesthesia. To determine the gold standard body surface area, the skin of the animals was dissected completely and measured. The gold standard was compared with the body surface area obtained in the same rats using the mathematical equations proposed by Meeh, Rubner, Vallois and San Roman. Analysis of variance showed statistically significant differences (p < 0.05) in body surface area results between the gold standard and Meeh's, Rubner'S, and San Roman'S equations. However, no significant differences were found with Vallols's formula, indicating that results with this calculation were similar to the measured body surface. Further statistical analysis showed that in the small animals the body surface area was underestimated and in the large animals it was overestimated by a mean of ± 20 cm2 using the Vallois formula. Zusammenfassung Die Messung der Korperoberflache bei Sprague-Dawley Ratten In der vorliegenden Untersuchung wurde die Korperoberflache von Sprague-Dawley Ratten gemessen und mit Resultaten aus mathematischen Formeln von vier verschiedenen Autoren verglichen. Die Tiere wurden durch eine Uberdosis von Ether getotet, um dann mit Hilfe des Umrisses der Haut die Korperoberflache zu messen. Die Ergebnisse aus der Hautoberflachen-Messung wurde mit den Gleichungen von Meeh, Rubner, Vallois und San Roman verglichen. Die Varianzanalyse zeigt deutliche statistische Unterschiede (p < 0.05) zwischen dem ermittelten Wert und den mathematischen Ableitungen bzw. Gleichungen von Meeh, Rubner und San Roman. Es wurden keine statistischen Unterschiede zwischen den vorliegenden Messungen und der Formel von Vallois gefunden. Das zeigt, das die Ergebnisse dieser Berechnung in ihrer Genauigkeit ubereinstimmen. Zusatzliche Analysen zeigen, das die Anwendung der Vallols'schen Formel die Korperoberflache kleiner Tiere unterschatzt und die groser Tiere um einen durchschnittlichen Wert von 20 cm2 uberschatzt.

The objective of this study was to determine the effect of TPN after surgery in patients with colon carcinoma and preoperative chemotherapy.The study included 27 patients, 16 men and 11 women, with a mean age of 62.1 +/- 11.2 years. The patients were divided into two groups according to whether they had undergone chemotherapy (Group A; n = 11) or not (Group B, control; n = 16) prior to surgery. Almost two thirds of the patients were in stage III of the disease. Among those receiving this treatment, 60% were given 5-fluorouracil plus leucovorin at a dose of 5.5 +/- 2.7 cycles/patient and the others received different regimens. TPN was established early with a mean of 11.7 +/- 9.2 days. The clinical and nutritional assessment was performed before surgery and at the end of TPN administration.The mean body mass index (BMI) was 24.1 +/- 2.2 kg/m2. Comparison between the groups before the start of TPN showed statistically significant differences in red blood cell and platelet counts (P = .013 and P = .02, respectively). These differences had disappeared at completion of TPN, suggesting that this treatment can reverse the hematological changes induced by chemotherapy.In patients who receive chemotherapy before surgery and in whom TPN it was indicated the combination of these two treatments could be beneficial.

The aim of this study was to determine serum dipeptidyl peptidase IV (DPP IV) levels in a population of short bowel syndrome (SBS) patients, who had achieved intestinal adaptation.DDP IV reference values were determined in a healthy population (n=47). The SBS study group consisted of 30 patients (17 men, 13 women; 53.2+/-13.2 years). The criteria for inclusion were a remnant small bowel200cm with or without colon resection. The time interval between resection and DPP IV measurement was24 months except in 4 patients, in which it was 13-24 months (total mean: 64.7+/-47.3 months). Nutritional support was exclusively oral in 17 patients, oral plus cyclic TPN in 12 and TPN alone in one patient.The reference range for DPP IV was 10-23U/l (mean: 16.01+/-3.2). In the group of SBS patients, mean serum DPP IV was 14.02+/-3.6U/l and mean body mass index 22.07+/-4.1kg/m(2). Eleven patients (36.6%) had hyperphagia and mean DPP IV in this group was 15.2+/-4.9U/l.Measurement of DPP IV levels in this limited series of SBS patients who had reached intestinal adaptation showed normal levels and did not provide additional clinical information. Further analysis in the earlier postoperative period will determine whether this enzyme has a role as an indicator of evolution in these patients.

Starting the first 24 hours after burn injury, energy supply, antioxidants and polyamines were assessed in 25 severe burn patients (20 men and 5 women) with a mean age of 45.6 +/- 20.4 years. Nutritional assessment was performed at 7, 15 and 21 days and was compared with a control group (n = 30). In 21 patients the burned body surface area was 20%-50% and in four patients it was greater than 50%. A mean decrease in energy supply of approximately 40% versus the calculated theoretical value was found in the three periods: 1,186 +/- 32; 1,117 +/- 589 and 1,331 +/- 578 kcal. In the first 15 days antioxidant ingestion was slightly lower than the recommended daily allowance for vitamin C: 60 mg versus 57 +/- 32, 57 +/- 53 and 75 +/- 53 mg, and was lower during the entire period for vitamin E: 10 mg versus 5.0 +/- 2.9; 4.5 +/- 3.0 and 5.3 +/- 3.4 mg; selenium: 40 microg versus 22.8 +/- 13.7; 22.5 +/- 9.8 and 25.7 +/- 11.2 microg and zinc: 12 mg versus 7.3 +/- 3.0, 6.8 +/- 4.8 and 8.4 +/- 5.3 mg. Taurine ingestion decreased on day 15 and significantly increased on day 21: 65.7 +/- 30 mg, 50.9 +/- 25 and 72.0 +/- 29 mg (p0.05). Ingestion of total polyamines did not differ significantly from the values observed in the control group and were as follows: day 7, total 45.2 +/- 23.0 umol, putrescine 16.7 +/- 10.2, spermidine 13.5 +/- 7.6 and spermine 13.6 +/- 8.8; day 15: total 41.1 +/- 38.5 and 14.9 +/- 4.0, 11.7 +/- 9.4 and 10.89 +/- 9.0; day 21: total 39.1 +/- 35.3 and 15.4 +/- 16.9, 12.3 +/- 11.4 and 17.3 +/- 16.8 umol, respectively.

Background and Aims: The small intestine contains several enzymes involved in arginine synthesis and converts glutamine to citrulline, the major compound for endogenous arginine synthesis. This study was conducted to assess the plasma status of urea-cycle intermediates and orotic urinary excretion in short-bowel patients. Methods:Thirteen stable short-bowel syndrome patients (7 men; 60.2±15.2 years) were studied. Patients were divided into moderately resected (Group A; n=6) and severely resected (Group B; n=7) according to their remnant bowel length (Group A: 61–150 cm; Group B: ≤60 cm). All subjects were consuming an oral diet plus dietetic supplements. Plasma urea-cycle amino acids, ammonium and urinary orotic acid were determined. Results: Plasma glutamine levels were significantly higher in both patient groups than in the control group (P

This study determines the effects of taurine (Tau) on phagocytosis of polymorphonuclear neutrophils (PMN) isolated from normal subjects (n = 41) and severely burned patients (n = 20). Phagocytosis was measured by nitroblue of tetrazolium (NBT) reduction in samples with and without latex bead stimulation. Taurine was added at doses of 0.2, 0.4, 0.8 and 1.6 mM to stimulated samples. In control cells there were statistically significant increases in phagocytosis after addition of Tau 0.8 mM and 1.6 mM to as compared to samples without Tau addition (295 +/- 23% and 330 +/- 35% vs. 248 +/- 18%; mean +/- S.E.; p0.05). A statistically significant increase in phagocytosis was observed in cells from the burned population after addition of Tau 1.6 mM (288 +/- 38% vs. 198 +/- 13%; mean +/- S.E.; p0.05). No changes in phagocytosis were found in cells from a subgroup of burn patients (n = 13) followed over 7, 15 and 21 days. These results indicate that taurine supplementation in vitro at doses of 0.8 to 1.6 mM improves the phagocytic capacity of neutrophils in healthy subjects and in patients with severe burn injury, mainly when neutrophil function is unaltered.

Polyamines are extremely important for cell growth, a fact that is reflected in the strict control of their synthesis and breakdown. In the small intestine, the polyamines play a fundamental role in all processes involving tissue regeneration, such as healing of stress-related ulcers, post-hepatectomy hepatic regeneration, adaptation syndrome after fasting and all processes with enterocyte hyperplasia or hypertrophy. In the gastrointestinal tract, there is a polyamine gradient in the villi-crypt cell axis and along the digestive tube, itself; the segments with greatest luminal content are the jejunum and the colon. Endogenous polyamine synthesis is stimulated by the diet and normal bacterial flora, which, in turn, regulate the amount and concentration of polyamines. Other hormonal and active peptide components (e.g. gastrin, epidermal growth factor, growth hormone) also have an influence on the pathway of polyamine synthesis. The interaction of these factors as related to the intestinal adaptive response is reviewed.

The effect of melatonin on inhibition of cell growth was studied in CT-26, a murine colon carcinoma-derived cell line. Cells growing in exponential phase were exposed to low (10(-7)-10(-10) M) and high doses (1, 2 and 3 x 10(-3) M) of melatonin during 24 h. Synthesis of DNA was measured by 5-bromo-2'-deoxyuridine incorporation. There was no effect at low doses, but a statistically significant correlation was found between the decrease in DNA synthesis and the dose of melatonin used (r = -0.52, P0.001). This implied the following percentages of inhibition: 1 mM, 22%; 2 mM, 25%; 3 mM, 47%. Potential cell membrane damage by high doses of melatonin was investigated by lactate dehydrogenase measurement and no significant levels were observed. Analysis with a single saturation technique showed no detectable oestradiol receptors in this cell type; therefore, we can assume that the effects occurring with the addition of melatonin were not mediated by modulation of this hormone on oestrogen receptors. The decreases in cell growth were attributed to a moderate, but significant antiproliferative action of melatonin on this non-hormone-dependent cell line.

The polyamines, putrescine, spermidine and spermine, are low-molecular weight substances, synthesized in eucariot cells from their immediate precursor, ornithine. These nitrogen compounds are essential for growth. The organism's endogenous supply is obtained through the diet or by synthesis in the intestinal flora. The polyamines are found in fruits and vegetables, foods of animal origin (milk, eggs, fish, and meat) and fermented food products (cheese, beer, and sauerkraut). Being nitrogenated compounds, they are considered as "minor" components of the diet. Ornithine decarboxylase, a short-half life enzyme, is the key to polyamine biosynthesis. Cellular polyamines are found in free or conjugated forms, the latter made possible, above all, by the presence of positive charges in their molecules. Their particular structure facilitates interaction with anions and binding to nuclear and membrane structures, particularly phospholipids, proteins and DNA. The organism's requirements for these substances are elevated during phases of intense growth or increased demand; thus, the nutritional supply can be crucial during the evolution of processes that involve a high degree of loss combined with deficits in endogenous biosynthesis. Increased tissue and organ polyamine concentrations correlate with diseases of neoplastic origin. It has been hypothesized that polyamine inhibition could be a therapeutic mechanism for such conditions. The supply of polyamines in artificial nutrition has not been measured and there are few data on the effects of artificial nutrition on circulating levels or the usual sites of storage in the body.

The enormous amount of data available for clinical and research purposes has made information searching a complex task. We have designed a study to determine which bibliographic databases provide appropriate information for the field of artificial nutrition. Of the 149 databases consulted in the preliminary search, 15 were found to contain an appreciable number of titles related to our field. As a general result, we found that MEDLINE had the largest number of titles but other databases oriented toward more specific topics contained references that were unique to them. The results show that an exhaustive search for any topic concerning artificial nutrition must be done on MEDLINE, EMBASE and Current Contents (75% productivity). These can be complemented with others according to their specialization in the subject to be treated. To obtain productivity over 75%, from five to seven databases must be consulted, according to the item under study.

Epidermal growth factor (EGF) was isolated in 1969 by Stanley Cohen in the submaxillary gland of the rat, and its structure was described by Taylor and Cohen in 1972. EGF is a 53-residue polypeptide, weighing 6372 daltons. It is synthesized in a precursor form, as Prepro-EGF, and is secreted into the saliva, intestine and urine. The degradation of EGF takes place primarily in the liver and secondarily in the digestive tract and kidney. EGF is a powerful mitogen, acting upon several types of cells. The epidermal growth factor receptor (EGF-R) is a 170,000 dalton glycoprotein which binds equally to EGF and transforming growth factor alpha (TGF-alpha), a constituent closely homologous to EGF. Presently, published studies concerning the use of EGF in parenteral and enteral nutrition are limited to experimental animals, in which clear effects on cellular proliferation have been observed. It has an important function in the digestive tract, protecting the gastric mucosa from stress and necrotizing agents. Thus, it might be useful in a new nutritional strategies, serving to combine the clearly beneficial effects provided by protein intake (non amino acid with those of the intestinal trophic and growth factors, in both parenteral and enteral nutrition.

Evidence for epidermal growth factor (EGF) involvement in the physiological response to burns was sought from urinary levels of EGF, urea and creatinine in male rats using a standardized thermal skin injury model (25 per cent body surface) and treated with fluid resuscitation. Postmortem, the skin lesions were studied by microscopy to guarantee the absence of inflammatory complications. Statistically significant differences were observed in body weight, urea and creatinine excretion when compared to the basal values. When EGF excretion results were evaluated as raw data (expressed as ng/mg of creatinine or ng/day) compared to basal levels, no statistically significant differences were observed. However, when the results were expressed as percentage increases with respect to the basal values, a statistically significant increase was found over the first 7 days postinjury (P = 0.029).

Human dermal fibroblasts were cultured and aged in vitro. Survival of young and aged fibroblasts was determined in the presence and absence of different concentrations of two vitamins. Vit C at doses of 5, 12.5, 25 and 50 mumol/L and water-soluble Vit E (Trolox) at 1, 5, 10 and 50 mg/L, were added 30 minutes before oxidative stress, consisting of exposure to 5 mM hydrogen peroxide for 30 minutes. A non-radioactive cell proliferation cytotoxicity assay (MTT) was used to determine the protective effect of the vitamins studied. Vit C produced a clear cytoprotective effect on aged cells over the entire range of doses applied. The protection provided by Vit E, was less pronounced.

Radiation therapy induces morphological and functional changes in small intestine leading to nutrient malabsorption. The aim of this study was to determine the effect of total abdominal irradiation on body weight in rats. The study was performed in four groups of animals treated at increased levels of radiation: 400, 600, 800 and 1,000 cGy. The decrease in body weight observed was similar at the caloric and nitrogen intake and were more pronounced as the dose of radiation increased.

This study was focused on the effects produced by diets with different amino acid proportions on visceral protein synthesis (liver and jejunal mucosa). Eight groups of rats received an enteral modular diet supplemented with different amino acids (Group 1: Ile, Leu, Val; Group 2: Phe, Met, Gly; Group 3: Glu, Arg, Gly; Group 4: Gly, Group 5: Orn-Asp, Cys, Pro; Group 6: Lys, Ser, Thr; Group 7: Tyr, His, Ala). Group 8 was the control group. Rats were fed for four days. At the end of this period a flooding dose of 14C-Leu was injected and animals were killed. Liver and jejunal mucosa were removed and protein synthesis rate was determined. Results show a decreased liver protein synthesis in group fed with aromatic amino acids (53.8 +/- 8.4 vs. 88.6 +/- 12.1) and Glu-Arg (68.6 +/- 10.9). In jejunal mucosa there was a decrease of protein synthesis in groups fed with aromatic amino acids (98.7 +/- 16 vs 160.5 +/- 49). These changes seem to be related to the intracellular amino acid pool size and its influence on protein metabolism.

Given the malnutrition present in patients suffering from advanced hepatic illness, as well as the implications of this in the post-hepatic transplant period, a study was made of various biochemical parameters (prealbumin, retinol-bound protein, zinc, magnesium, cholesterol and amino acid pattern) as indicators of the nutritional condition of a series of 15 patients who underwent hepatic transplants and required total parenteral nutrition (TPN) during the first 10 post-transplant days. Before the transplants were carried out, all the patients studied showed a decrease in all evaluated parameters. Ten days after the transplant, and having been fed parenterally during this time, the different parameters corrected themselves, with the exception of cholesterol. TPN, administered with enrichment of branched amino acids by 35%, practically normalized the plasma amino acid pattern.

The effect of the lipidic composition of the diet on the proteic synthesis of the male Sprague-Dawley rats fed parenterally for four days has been studied. All animals received identical nitrogen and caloric intake, but the ratio of medium to long-chain triglycerides (MCT/LCT) varied: group 1, control (0/100); group 2 (30/70); group 3 (50/50) and group 4 (70/30). Hepatic and jejunal protein synthesis were determined with L-(1-14C)-leucine. In groups 1, 3 and 4 muscle protein synthesis was measured with L-(3,4-3H)-phenylalanine. In liver, there were no significant differences in the fractional synthesis rate among the groups. In jejunum, the control group showed a higher fractional synthesis rate with statistically significant differences among the groups. In muscle, group 3 presented the highest fractional synthesis rate with statistically significant differences (p less than 0.05).

Malnutrition leads to cellular and humoral immunological response disorders. A study protocol on malnourished patients has been designed in order to assess immune response mechanisms that may be altered due to malnutrition and may or may not recover once normal metabolic conditions have been restored prior to starting the patient on parenteral feeding and control. The immune response was assessed especially regarding immunoglobulin, lymphocyte subsets and mitogen response levels. It is important to know the different malnutrition-related immunologic disorders, disorders secondary to diseases that hinder correct oral feeding, and immunologic tests may be used to assess nutritional parameters. The malnourished patients included in this trial has to be free of any other immunologic or neoplastic disease, and not receive immune response suppression therapy. The trial patients showed lower total and relative CD3 and CD4 lymphocyte values at the onset of the study, although the former lymphocyte subset recuperated sooner at the expense of increasing CD8 lymphocytes, while CD4 lymphocytes still remained low after 15 days of parenteral nutrition. Immunoglobulin levels remained within normal limits. The mitogen response capacity, which was sensibly low at the beginning, recuperated in 50% of the cases treated with parenteral nutrition. This parameters may be used as an index to assess the nutritional status of these patients. The cases studies allowed us to conclude that there was a decrease in CD4 cells and mitogen response in malnourished patients. After 15 days of parenteral nutrition, the cells did not recuperate but their function measured in terms of phytohemagglutinin, was normal in 50% of the cases.

The aim of this study is to demonstrate the possibility of using the peritoneal route for carrying out periodical dialysis (PPD) together with supplying amino acids (AA's) for nutritional purposes and, at the same time, to determine the influence of the pattern of the mixture of AA's used for this purpose. In order to carry out this study we established three different groups. The PPD technique was the same for all the patients. In the control group PPD was performed without the addition of AA's. In groups 2 and 3 PPD was carried out with the addition of AA's and two different patterns were respectively used for that purpose.

A protein breakdown study was carried out in ten post-operative patients, 24 hours after operation and after five days of peripheral parenteral nutrition; five of these patients were in a good nutritive condition (group A) and five were suffering from malnutrition and were critically ill (group B). Results indicate that the administration of amino-acids achieved a decrease in the degree of protein breakdown in the two groups under study, and also it was observed that better use was made of the nitrogen administered, particularly by the liver when the nitrogenous supply is completed with carbohydrates such as glucose. The difference obtained in values between the oxidized leucine and the leucine administered suggests that there is an endogenous donor pool, and the differences existing between breakdown and leucine oxidation values indicate that in group A, nourished solely with amino-acids, breakdown is lesser and oxidation greater than in group B, nourished with amino-acids and glucose, which suggests that there is more stimulation to re-use the amino-acids in this group.

To evaluate the incorporation of branched-chain amino-acids (BCAA) in de novo synthesised albumin, a series of experiments was performed with cultured hepatocytes from normal (Group 1) and stressed rats (groups 2 and 3). Stress was induced by keeping the rats immobilised in a cold room for 6–8 h and assessed by the presence of bleeding ulcers in the stomach. The cells were cultured in a commercial synthetic medium (Ham F-12) poor in BCAA (5.74% of total) increasing amounts of BCAA were added to plates in groups 1 and 2 and equivalent quantities of nitrogen in the form of glycine were added to plates in group 3. In group 1, the increase in BCAA concentration from 22.74–210.8 mg/ml was followed by an increase in the albumin synthesis rate from 0.4–0.95 ug/mg cell prot/h. In group 2, the rise in BCAA was followed by a far greater increase from 0.3–5 ug/mg cell prot/h (at least 6 times normal levels). In group 3, only 20% of the increase in albumin synthesis obtained in group 2 was observed. These results suggest that in stress the liver increases the use of BCAA for protein synthesis, but the increase of nitrogen in the culture medium respresents only a low percentage of this effect.

Protein synthesis in isolated perfused rat livers has been studied. Aminoacids at physiological rat concentration (U-14C)-Leucine 0.065 muCi/ml and N Tau-Methylhistidine His (Tau-Me) were added to the perfusion medium. His (Tau-Me) from 0.01 to 2.0 mM causes a reduction between 40-60% in the rate of secreted proteins, independently of the His (Tau-Me) concentration.

The aim of this study was to evaluate the effect of total parenteral nutrition (TPN) with 100% long-chain triglyceride (LCT) (group A) and 50/50% medium/long-chain triglyceride (MCT/LCT) (group B) fat emulsions on visceral protein synthesis in 70% hepatectomized rats. The rats were fed TPN continuously for 7 days posthepatectomy. Protein synthesis was measured in the liver and jejunal mucosa with the flooding dose method. All rats received the same caloric and nitrogen intake, without statistically significant differences. The only difference between the two groups was the proportion of MCT to LCT in the diets. Hepatic and jejunal mucosa protein synthesis were significantly higher in group B, fed 50/50% MCT/LCT. These results suggest that fat emulsions with 50/50% MCT/LCT significantly enhance visceral protein synthesis after partial hepatectomy.