The data published on the modifications of amino-acid metabolism associated with variations of obesity from genetic or hormonal origin have been reviewed. In the first part monogenic models of mice and rats are described. Obesity in humans is analysed in the second part. Lastly, non-ruminant genotypes or hormone-treated ones (chickens and pigs) are reviewed in the third part. Although different mechanisms are probably at the origin of these differences, many similarities can be drawn. Obesity is always associated with: 1) less efficient utilization of dietary amino acid; 2) a high concentration of branched-chain amino acids in plasma; 3) a deviation of carbon from amino acid towards gluconeogenis and lipogenesis; and 4) a less pronounced sensitivity to amino-acid imbalance in the diet.

Adipose Tissue↗

PubMed1994

Comparative responses of genetically lean and fat chickens to lysine, arginine and non-essential amino acid supply. I. Growth and body composition.

1. Three experiments were performed to study the effects of amino acid imbalance on the growth of genetically lean (LL) or fat (FL) male chickens from 28 to 42 d of age. In experiment 1, five concentrations of digestible lysine were compared (4.75, 6.75, 7.75, 8.75 and 9.75 g/kg). In experiment 2, four concentrations of digestible arginine were compared (6.53, 7.69, 8.84 and 10.0 g/kg). In experiment 3, three diets were compared: a high-protein diet (189 g CP/kg), a low-protein diet containing added essential amino acids (EAA) (144 g CP/kg) and this low-protein diet supplemented with 40 g/kg of non-essential amino acids (NEAA) (glutamic acid+aspartic acid). 2. LL birds exhibited a lower growth rate than the FL when the diet was deficient in either lysine or arginine. Plotting weight gain against lysine or arginine intake suggested that most of this effect was caused by variations in food intake. 3. When protein gains (body or total proteins) were plotted against lysine or arginine intake, LL chickens appeared more efficient than FL chickens. 4. Similar growth rates, although slightly lower in FL, were obtained with low- and high-protein diets. However, NEAA supplementation of the low-protein diet reduced adiposity of LL and did not modify that of FL. Increasing crude protein content (all amino acids) was more effective than NEAA supplementation in decreasing the adiposity of both lines.

Amino Acids↗

PubMed1994

Comparative responses of genetically lean and fat chickens to lysine, arginine and non-essential amino acid supply. II. Plasma amino acid responses.

1. Three experiments performed to study the effects of amino acid imbalances on the growth of genetically lean (LL) and fat (FL) male chickens from 28 to 42 d of age were described by Leclercq et al. (1994). The plasma amino acid concentrations of birds on selected treatments from that paper are reported here. In experiment 1, three dietary concentrations of digestible lysine were compared (4.75, 6.75 and 7.75 g/kg). In experiment 2, two dietary concentrations of digestible arginine were compared (6.53 and 10.00 g/kg). In experiment 3, three diets were compared: a high-protein diet (189 g CP/kg), a low-protein diet containing added essential amino acids (144 g CP/kg), and this low-protein diet supplemented with 40 g/kg of non-essential amino acids (NEAA; glutamic and aspartic acids). 2. The present results are compared with two earlier reports on the same genotypes. The LL consistently had lower plasma concentrations of methionine, cystine, phenylalanine, isoleucine and valine, and higher concentrations of histidine, than the FL chickens. In 4 of 5 experiments, LL leucine concentrations were lower, and glutamic acid, tyrosine, glutamine and alanine were higher, than in the FL. The other amino acids measured; arginine, lysine, aspartic acid, glycine and serine, exhibited variable responses among the experiments. 3. When the limiting essential amino acids, lysine and arginine, were added to a deficient diet, the plasma concentration of the supplemented amino acid increased while the others remained constant or decreased. 4. When glutamic and aspartic acids were added to the low protein diet, plasma amino acid responses were similar to those of adding a limiting amino acid to a deficient diet, except that alanine exhibited a dramatic increase. 5. Although there were genotype by diet interactions for several amino acids, the interactions were caused by differences in the degree of the responses, not in their direction. 6. These results suggest that the FL and LL genotypes do not utilise various amino acids with the same efficiency and, as a consequence, the ideal profile of dietary amino acids should not be the same for both lines. The results support the hypothesis that selection for fatness and leanness changed the amino acid requirements independently of the effects of food intake.

Amino Acids↗

PubMed1994

Do bacteriuria and candiduria have predictive value in the diagnosis of postlaparotomy peritonitis?

Explore the source record for details and available documents.

Aged↗

PubMed1994

Myocardial imaging with technetium-99m-tetrofosmin: comparison of one-day and two-day protocols.

UNLABELLED: There is no evidence of myocardial redistribution after tetrofosmin injection, therefore, two separate injections are needed to differentiate scar from ischemia with this tracer. The injections can be given on the same day (one-day protocol) or on separate days (two-day protocol). As part of a Phase II clinical study, a one-day protocol was compared with a two-day protocol. METHODS: Fifty-five patients with suspected coronary artery disease were studied according to the following protocol: on the first day at rest, anterior, left lateral, left anterior oblique 40 degrees and 70 degrees images were acquired 30 min after injection of 8 mCi of tetrofosmin for 5 min each. Two days later, exercise and rest images were acquired on the same day. At peak exercise, 8 mCi of tetrofosmin were injected and 30 min later the same four standard planar images were recorded as on Day one. Four hours after the exercise injection, 24 mCi of tetrofosmin were injected at rest and imaging was repeated 30 min later. Qualitative comparisons between the one- and two-day protocols were performed in 50 patients in whom all data were available following blinded evaluation of images by three readers. RESULTS: All three readers reported identical results for the 26 patients. A difference in extent or location between the observers was found in seven patients, differences between normal and abnormal in eight patients, while discrepancies between ischemia and necrosis were noted in four patients. In five patients, an ischemic area was found according to the one-day protocol, but according to the data of the two-day protocol, this area was judged to be necrotic. One observer reported the opposite in one patient. These discrepancies between the reversibility of defects were restricted to the inferior wall. Comparison with 201Tl data showed no systematic pattern of variation. CONCLUSION: Tetrofosmin can be used in a one-day protocol. However, in planar imaging, the inferior wall should be reported with caution.

Coronary Disease↗

PubMed1994

Treatment of peritoneal carcinomatosis by intraperitoneal chemo-hyperthermia: reliable and unreliable concepts.

Intraoperative peritoneal chemo-hyperthermia (IPCH) is a promising treatment of peritoneal carcinomatosis arising from digestive tumors. After presenting the rationale for the use of IPCH, this review reports the results published to date by different groups. Unfortunately, data with respect to technical aspects, indications and results are unclear, inhomogeneous and questionable. The discussion presents reliable and unreliable points, mainly concerning the technical aspects of IPCH: what is the maximal desirable tumor thickness before initiating treatment? What is the ideal temperature? Is central hyperthermia beneficial? What is the ideal duration? What is the most effective antimitotic drug? A new classification of peritoneal seeding before cytoreductive surgery and before the initiation of IPCH, is proposed, and a suggestion concerning the reporting of drug concentrations made. Numerous prospective studies need to be conducted to test different technical modalities and to evaluate the results of IPCH.

Animals↗

PubMed1992

Lipogenesis in turkeys and chickens: a study of body composition and liver lipogenic enzyme activities.

1. Carcase composition, fat deposition and the activities of three liver lipogenic enzymes were compared in turkeys and chickens fed ad libitum on two different isocaloric diets, respectively adapted to chickens (C) and to turkeys (T). Diets differed in their protein content, being higher by 60 g/kg in diet T. 2. Chickens were much fatter than turkeys and exhibited higher activities of acetyl-coenzyme A carboxylase (EC 6.4.1.2) and malic enzyme (EC 1.1.1.40). 3. The carcase composition of turkeys was not influenced by the type of diet administered, while chickens fed on diet C were fatter than chickens fed on diet T. Compared to diet T, diet C enhanced malic enzyme activity, whatever the species and age. 4. A good correlation between abdominal fat and total fatness was observed in both species but especially in turkeys. 5. In conclusion, hepatic lipogenesis is much lower in turkeys than in chickens.

Acetyl-CoA Carboxylase↗

PubMed1991

Wegener's granulomatosis presenting as diffuse pulmonary hemorrhage.

A 35-year-old woman experienced diffuse intraalveolar haemorrhage with respiratory distress and acute renal failure. Renal histology and evolution confirmed Wegener's granulomatosis. Early use of immunosuppressive drugs allowed weaning from mechanical ventilation and temporary improvement of the renal failure. A review of the literature emphasizes the rarity of alveolar hemorrhage as an initial symptom of Wegener's granulomatosis and the necessity of aggressive management.

Adult↗

PubMed1991

Further investigations on protein requirement of genetically lean and fat chickens.

1. Genetically lean (LL) or fat (FL) chickens were fed from 28 to 42 d of age on one of 6 diets with different protein contents (from 73 to 208 g/kg). In order to keep a constant amino acid balance the experimental diets were made by diluting a well-balanced protein-rich diet with a protein-free diet. 2. Dietary protein influenced the growth rate of both genotypes similarly. However, maximum weight gain was reached in LL at a lower protein intake than in FL. 3. Regression between total protein gain (body protein + feather protein) or body protein gain and protein intake exhibited significantly different slopes, that of LL being superior to that of FL. 4. At a given protein intake, feather protein gain was also superior in LL to FL. Moreover feather protein, as a percentage of total protein gain, was superior in LL to FL. When the dietary protein fell below 126 g/kg, feather protein represented a higher proportion of total protein gain. 5. Multiple linear regressions of protein intake (as the dependent variable), and body weight and protein gain or weight gain (as the independent variables) suggest that the maintenance requirement for protein is similar in both lines but that the protein efficiency for growth is significantly superior in LL. 6. In a second experiment both genotypes were offered either a single high protein diet (232 g/kg) or a single medium protein diet (186 g/kg) or had free-choice between a high (269 g/kg) and a low protein (145 g/kg) diet. In free-choice feeding, FL chickens selected an overall dietary protein content which was significantly lower (179 v. 200 g/kg) to that of LL. In both genotypes, free-choice feeding led to fatter and less efficient chickens than predicted by the linear regression between adiposity or food conversion and protein content.

Amino Acids↗

PubMed1991

Normal number and kinase activity of insulin receptors in liver of genetically fat chickens.

Genetically fat (FL) chickens exhibit an increase in liver lipogenesis and, in the fasting state, insulin sensitivity compared with genetically lean (LL) chickens. Liver insulin receptor number and insulin receptor kinase (IRK) activity were studied at 5 wk. In the fasting (16 h) and fed state, insulin binding to liver membranes and insulin receptor affinity (50% inhibition of tracer binding, range: 5-7 ng/mL at 4 degrees C) were very similar in fat and lean chickens. Insulin degrading activity of membranes was negligible for both genotypes. Following solubilization with Triton X-100, liver receptors were purified either on wheat germ agglutinin (WGA receptors) or on lentil then wheat germ lectins (lentil receptors). Both types of purified receptors exhibited the same binding affinity, independent of the genotype or the nutritional state. Autophosphorylation and IRK activity toward artificial substrate poly(Glu, Tyr)4:1 were not different between genotypes. Basal IRK (i.e., in the absence of insulin) was decreased by the overnight fast. Fattening of genetically fat chickens cannot be accounted for by an increase in the number or the kinase activity of liver insulin receptors. Steps following the binding or the receptor kinase may be involved.

Animals↗

PubMed1991

Prolonged exercise induces left ventricular dysfunction in healthy subjects.

To determine the effects of a moderately prolonged exercise on left ventricular systolic performance, 23 healthy male subjects, aged 18 to 51 yr (mean 37 yr) were studied. The subjects exercised first on a treadmill (brief exercise) and completed, on a separate day, a 20-km run. M-mode, two-dimensional, and Doppler echocardiography, as well as calibrated carotid pulse tracings, were obtained at rest and immediately on completion of both brief and prolonged exercise. Left ventricular systolic function was assessed by end-systolic stress-shortening relationships. Heart rate increased similarly after brief and prolonged exercise (+30%). Mean arterial pressure decreased from 99 +/- 7 to 92 +/- 8 mmHg (P less than 0.001) after prolonged exercise, but it remained unchanged after brief exercise. Left ventricular end-diastolic volume was decreased after prolonged exercise (130 +/- 23 vs. 147 +/- 18 ml at rest, P less than 0.01). Both ejection fraction and rate-adjusted mean velocity of fiber shortening decreased after prolonged exercise [from 67 +/- 5 to 60 +/- 6% (P less than 0.001) and from 1.12 +/- 0.2 to 0.91 +/- 0.2 cm/s (P less than 0.001), respectively] despite a lower circumferential end-systolic wall stress (133 +/- 23 vs. 152 +/- 20 g/cm2). The relationship between ejection fraction (or mean velocity of fiber shortening adjusted for heart rate) and end-systolic wall stress was displaced downward on race finish (P less than 0.05). These changes were independent of the changes in left ventricular end-diastolic volume and hence those in preload. The data suggest that moderately prolonged exercise may result in depressed left ventricular performance in healthy normal subjects.

Adult↗

PubMed1991

Heat and moisture exchanger vs heated humidifier during long-term mechanical ventilation. A prospective randomized study.

Adequate humidification of inspired gases with HMEs during long-term MV remains controversial. In this study, a comparison is made between tracheal secretions during long-term MV either with HME or conventional HH. Both the HME and HH groups were similar with respect to age, sex, diagnosis, duration of MV, SAPS and mortality. Temperature of gases in the tracheal tube was lower and the amount of tracheal instillations was greater in the HME group than in the HH group. Tracheal secretions became thicker between day 1 (control) and day 5, in the HME group than in the HH group. Four and two tube occlusions occurred in HME and HH groups, respectively. Tracheal bacterial colonization was similar in the two groups. Given the advantages of HME (reduced nurses' work and financial cost), HME could be routinely used under cautious surveillance and replaced by HH if difficulty in suctioning occurs.

Female↗

PubMed1990

Acute myocardiotoxicity during 5-fluorouracil therapy.

A 38-year-old man with a colonic carcinoma experienced cardiogenic shock during continuous intravenous treatment with 5-fluorouracil (5-FU), without clinical or electrical signs of coronary insufficiency and with a normal coronary angiogram. His symptoms resolved after eight days of inotropic and vasodilator therapy. Because of the severity of the shock, rechallenge was not performed. This is the first case of acute cardiac failure without coronary ischemia, associated with 5-FU monotherapy. Experimental studies suggest that this adverse effect could be due to myocardial accumulation of 5-FU leading to depletion of high energy phosphate compounds. This might also explain the more frequently seen acute coronary insufficiency due to 5-FU.

Adult↗