[What every physician should know about the new hospital food].
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Dietary Proteins↗
Biomedical subjects
H Andersson
Publications and source records attributed to H Andersson.
[Warning against erroneous data from pulse oximeters].
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Equipment Failure↗
Different positively charged amino acids have similar effects on the topology of a polytopic transmembrane protein in Escherichia coli.
Integral membrane proteins from a wide variety of sources conform to a "positive-inside rule," with many more positively charged amino acids in their cytoplasmic as compared to extracytoplasmic domains. A growing body of experimental work also points to positively charged residues in regions flanking the apolar transmembrane segments as being the main topological determinants. In this paper, we report a systematic comparison of the effects of positively (Arg, Lys, His) as well as negatively (Asp, Glu) charged residues on the membrane topology of a model Escherichia coli inner membrane protein. Our results show that positive charge is indeed the major factor determining the transmembrane topology, with Arg and Lys being of nearly equal efficiency. His, although normally a very weak topological determinant, can be potentiated by a lowering of the cytoplasmic pH. Asp and Glu affect the topology to similar extents and only when present in very high numbers.
Amino Acid Sequence↗
Effect of oat bran on plasma cholesterol and bile acid excretion in nine subjects with ileostomies.
A higher excretion of dry matter, fat, nitrogen, energy, and total bile acids in ileal effluents; a lower plasma low-density-lipoprotein (LDL) and total cholesterols (12.1% and 9.0% lower respectively); but no change in plasma high-density-lipoprotein (HDL) cholesterol or apolipoproteins A-I and B were observed in nine subjects with ileostomies when they consumed an oat-bran, bread-based, high-fiber diet (HFD) as compared with a wheat-flour, bread-based, low-fiber diet (LFD) for 3 wk with a crossover design. Of the nine subjects only the subjects with a low daily excretion of bile acids had an elevated excretion of total bile acids during the HFD compared with the LFD. Total cholesterol, LDL cholesterol, and apolipoprotein B in plasma also decreased by 11.3%, 15.3%, and 10.7%, respectively, after consumption of the HFD for 3 wk.
Adult↗
Fatal systemic poisoning after skin exposure to monochloroacetic acid.
Little information is available on the toxicity of monochloroacetic acid. We report the case of a 38 year-old man who was splashed with an 80% monochloroacetic acid solution on 25-30% of his body surface. In addition to epidermal and superficial dermal burns, features of systemic poisoning occurred within a few hours including disorientation, agitation, cardiac failure and coma. He later developed severe metabolic acidosis, rhabdomyolysis, renal insufficiency and cerebral edema, and died due to uncal herniation on d 8. The 4 h post exposure plasma monochloroacetic acid concentration was 33 mg/L confirming skin absorption. In addition to its corrosive action, monochloroacetic acid probably blocks the tricarboxylic acid cycle (Kreb's cycle) and may also react with sulfhydryl groups in enzymes, causing severe tissue damage in energy-rich organs.
Accidents↗
A retrospective study of osseointegrated skin-penetrating titanium fixtures used for retaining facial prostheses.
This investigation was conducted to evaluate osseointegrated skin-penetrating facial titanium implants used for anchoring facial prostheses over a 5-year period and to recommend guidelines for the use of osseointegrated implants in the restorative treatment of auricular and orbital defects. The total success rate for implant survival was 95.6% in the auricular defects and 67.2% in the orbital defects. Approximately 10% of the patients will have some skin problems, whereas the remaining 90% will have no or minimal problems. The possibility of achieving osseointegration around an orbital defect is not as good as in the mastoid process. Success criteria for the use of implants in the craniofacial region are given.
Adolescent↗
Nutrients and sterols excreted in ileostomy effluents after a diet with autoclaved amylomaize or ordinary corn starch.
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Bile Acids and Salts↗
The ileostomy model for the study of carbohydrate digestion and carbohydrate effects on sterol excretion in man.
The ileostomy model offers a method for direct, accurate and quantitative determination of small bowel excretion, provided the bacteriological degradation of the effluent can be minimized. The intraindividual variation is small, and rapid changes in excretion pattern due to dietary manipulations can be measured. Such ileostomy investigations have been important for developing the resistant starch and dietary fibre concepts. Using this method, various mechanisms for effects of dietary fibre on plasma lipids can be elucidated, e.g. binding of cholesterol, bile acids and/or lipids. Another application is to study the capacity of phytic acid and its degradation products to bind minerals in the small bowel.
Dietary Fiber↗
Olive oil instead of butter increases net cholesterol excretion from the small bowel.
Butter was replaced by olive oil in a controlled 100 g fat diet in order to study the effect of saturated fats (SAFA) versus monounsaturated fats (MUFA) on small-bowel sterol excretion in eleven healthy ileostomates. Bile acids and neutral sterols were measured by gas-liquid chromatography. Net cholesterol excretion (excretion minus intake) was 84 +/- 25 mg/24 h (mean +/- SE) on the SAFA diet and increased to 218 +/- 32 mg/24 h on the MUFA diet (P less than 0.01). The bile acid excretion tended to be somewhat lower on the MUFA diet, but this was significant only for chenodeoxycholic acid. Net sterol excretion (the sum of excretion of net cholesterol and bile acids) was significantly lower on the SAFA diet than on the MUFA diet (443 +/- 60 and 529 +/- 58 mg/24 h, respectively). The immediately increased excretion of cholesterol from the small bowel could thus explain the serum cholesterol-lowering effect of a change from a SAFA-rich to a MUFA-rich diet, though the mechanism for this change is still unclear.
Adult↗
Dietary treatment of dermatitis herpetiformis.
Essentially all patients with dermatitis herpetiformis (DH) and dermal granular IgA deposits have a gluten-sensitive enteropathy as seen in coeliac disease. A gluten-free diet would normally restore mucosal morphology within months. The dapsone medication required to suppress the skin lesions could be gradually reduced and/or finally discontinued in most patients if they constantly adhere to the diet. The immunological reactions may also be reduced. The gluten-free diet could thus be successful both concerning manifestations from the skin and the gut. Although well known in dermatological literature, diet therapy in DH has attracted little interest in journals of nutrition. A survey of this causal diet therapy for the disease therefore seems appropriate.
Dapsone↗
A 30-residue-long "export initiation domain" adjacent to the signal sequence is critical for protein translocation across the inner membrane of Escherichia coli.
Signal sequences serve to target proteins to the secretory pathway in both prokaryotic and eukaryotic cells. However, although necessary, the presence of a signal sequence is not always sufficient to ensure efficient membrane translocation. One feature of the nascent chain that adversely affects secretion, at least in Escherichia coli, is the presence of positively charged amino acids immediately downstream of the signal sequence. We have exploited this sensitivity to positively charged residues to demonstrate the presence of a sharply delimited "export initiation domain" that comprises the signal sequence and its approximately 30 downstream residues. A string of six consecutive lysines completely blocks translocation when placed inside this domain but not when placed only a few residues further away.
Amino Acid Sequence↗
The efficiency of the uncleaved secretion signal in the plasminogen activator inhibitor type 2 protein can be enhanced by point mutations that increase its hydrophobicity.
Plasminogen-activator inhibitor type 2 (PAI-2) is a specific inhibitor of plasminogen activators that belongs to the serine protease inhibitor superfamily (SERPINS). PAI-2 exists in two molecular forms: an intracellular, non-glycosylated form and a secreted, glycosylated form. Like ovalbumin, PAI-2 contains an uncleaved internal secretion signal. By deletion analysis, we have mapped the secretion signal to two mildly hydrophobic regions near the NH2 terminus. We also show that both of these regions become more efficient translocation signals when their hydrophobicities are increased. The PAI-2 secretion signal provides a unique example of a signal that, by virtue of its poor efficiency, allows the synthesis of both an extracellular and an intracellular form of the protein.
Amino Acid Sequence↗
Brewer's spent grain, serum lipids and fecal sterol excretion in human subjects with ileostomies.
A crossover design studying lipid and apoprotein levels in serum and excretion of sterol, nitrogen and fat in ileostomy effluent was performed in 10 subjects fed diets with or without supplementation with brewer's spent grain, which is the residue of barley after the brewing of beer. More cholesterol, nitrogen, fat and energy were excreted in the ileostomy effluents when the subjects consumed a brewer's spent grain supplemented, high fiber diet than when they consumed a low fiber diet. No significant change was found in the daily net sterol excretion. The six subjects with low daily excretion of bile acids (less than 1000 mg/24 h) had increased cholesterol and net cholesterol and decreased bile acid excretion per day, and lowered serum LDL-cholesterol and apoprotein B levels after supplementation with brewer's spent grain. We propose that subjects with low daily bile acid excretion are suitable models for studying the effect of dietary changes on sterol excretion and serum lipid levels. Increased fecal cholesterol excretion is suggested to be the primary mechanism for the serum LDL-cholesterol lowering effect of brewer's spent grain.
Adult↗
Culture of renal tubular cells from the urine of patients with nephropathic cystinosis.
Nephropathic cystinosis represents a prototype for lysosomal storage diseases and is the most common cause of renal tubular Fanconi's syndrome. Mechanisms of the tubular transport defects in this disease have not been defined, however, in part because the cells readily cultured from affected patients, leukocytes and fibroblasts, do not express epithelial transport functions. Except for a single autopsy report, renal tubular cells from these patients have not been studied in vitro. In these studies, noninvasive harvesting and culture of renal tubular cells from the urine of patients with cystinosis is described. Cultures of renal tubular cells could be established from over 50% of the isolates which contained viable cells and which remained uncontaminated in vitro. Cells had an epithelial morphology in culture, and the majority of cultured cells expressed proximal tubular brush border marker enzyme. Cultured cells also expressed the storage defect in vitro, containing cystine levels up to 100 times those of normal cells. Cultured cells could be depleted of cystine by using the thiol cysteamine. This in vitro model system should be very useful for studying the mechanisms of renal tubular transport defects in this disease.
Cells, Cultured↗
Truncal vagotomy reduces food and liquid intake in man.
Truncal vagotomy reduces food and liquid intake in laboratory animals but has not been studied in man. Seven (6F) morbidly obese patients kept 4-day dietary diaries with validation by urine nitrogen analysis before and 3 and 9 months after truncal vagotomy without drainage. Significant reductions in body weight were accompanied by reductions in self-reported total calorie intake from 2800 kcal/day to 1800 at 3 months and 2000 kcal/day at 9 months. The correlation between reported and validated protein intake was .72 (p less than 0.001) with a mean underreporting of protein intake by at least 27%. Macronutricant postoperative reductions in total volume and calorie density of liquid intake. Liquid calories were reduced by 47% at 3 months and 50% at 9 months and solid calories by 33% at 3 months and 27% at 9 months. It is concluded that truncal vagotomy reduces food and liquid intake in man preferentially through liquid reduction. These results have implications for surgical treatment of morbid obesity.
Adolescent↗
Absorption studies in patients six to 10 years after construction of ileostomy reservoirs.
The absorption of fat, bile salts, and vitamin B12 was studied in 14 proctocolectomised patients six to 10 years after construction of a continent ileostomy. All patients were in excellent health and displayed no signs of malnutrition. Schilling test disclosed subnormal absorption of vitamin B12 in one patient and borderline values in five. Faecal loss of bile acid was increased in 12 patients and fat malabsorption occurred in two. Except for slightly pathological liver tests in two patients, routine laboratory tests, including plasma concentration of vitamin B12 and folic acid, were normal. There were no signs of sodium or potassium depletion.
Adult↗
Faecal excretion of intravenously injected 14C-cholic acid in patients with conventional ileostomy and in patients with continent ileostomy reservoir.
Bile salt absorption, as determined by the faecal excretion in i.v. injected 14C-cholic acid (FBS) was studied in 13 ileostomy patients before and after conversion to Kock's continent ileostomy reservoir. The result was compared with that obtained in 8 ileostomy patients in whom about 50 cm of the terminal ileum has also been removed. As compared with 16 healthy controls, FBS was moderately increased in the conventional ileostomy patients, but still within normal limits. After conversion to ileostomy reservoir all patients had pathological FBS, although less severe than in the ileostomy patients with ileal resection. Bacterial contamination probably contributes more than the structural mucosal changes to the bile malabsorption in the pouch, whereas reduced mucosal surface and short small-intestinal transit time are the main causes of malabsorption in ileostomy patients in whom an appreciable amount of the terminal ileum has been resected.
Adult↗
Transit time in constipated geriatric patients during treatment with a bulk laxative and bran: a comparison.
Transit time, as estimated from the passage through the gut of an isotope (131I)-containing capsule, was studied in 10 constipated, geriatric in-patients on a bulk laxative regimen and during treatment with wheat bran. The patients received a conventional bulk laxative (Vi-Siblin, 6 g twice daily) during a period of 8 weeks. The bulk laxative was then replaced by bran (10 g twice daily) during the following 8-week period. Measurements of transit time were taken after 4 and 6 weeks on each regimen. The mean transit time was 126 h for the bulk laxative regimen and 89 h for the bran treatment, the difference being statistically significant. The decrease in transit time for the bran treatment was essentially due to a faster passage through the rectosigmoid part of the bowel. Less additional laxative therapy was needed during bran treatment than during the bulk laxative treatment. The favourable properties of bran may tentatively be explained by the effects remaining in the distal part of the colon. A slight but significant lowering of the serum calcium level and a significant increase of the total iron-binding capacity of the serum were found after 7 weeks of bran administration, whereas no change was observed after 42 weeks. No significant change was demonstrated in serum iron during bran treatment.
Aged↗