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Biomedical subjects

L Babcock

Publications and source records attributed to L Babcock.

3 recordsLinked to original sources

Modulation of complement fixation and the phlogistic capacity of group A, B, and D streptococci by human lysozyme acting on their cell walls.

Streptococci and streptococcal cell wall fragments induce arthritis in rats, with the severity and duration depending on the capacity of the cells or cell fragments to resist degradation by tissue enzymes. Their phlogogenic effects are apparently related to their ability to activate the alternate complement pathway (ACP). The in vitro activation of the ACP by lysozyme-treated cells and cell walls of group A, B, and D streptococci suggests that both rat and human lysozyme can modulate this activity, i.e., increasing it, decreasing it, or doing both in that order. The effects of the lysozymes also correlated with the degree to which they can unmask the aminosugar-reducing groups detectable in a given amount of cell wall, which suggests that partial depolymerization of the cell wall is critical for ACP activation. The effects of mutanolysin and C phage lysin on ACP activation were found to be correlated with their action on streptococcal cell walls. Neuraminidase had relatively little effect on ACP activation by most streptococcal strains tested. We conclude that the participation of tissue enzymes, including but not necessarily limited to lysozyme, is an important determinant for the clinical arthritis induced by group A, B, or D streptococci. Experimental arthritis induced in rats with whole (or disrupted) streptococci may depend both on the capacities of the cell walls to activate the ACP and on the capacities of the host tissue enzymes to modulate this activation. Great severity and long durations of the disease were determined by the capacity of the enzymes to degrade cell wall antigens to a degree sufficient to ensure efficient activation of the ACP without completely degrading the material so that it no longer activates complement. In this model, the limited resistance of group B peptidoglycan to lysozyme was a critical pathogenic factor.

Animals↗

Early postoperative jejunal feeding of elemental diet in gastrointestinal surgery.

Gastric and colonic ileus after major abdominal operation precludes normal oral nutrition in the immediate postoperative period. Since small bowel motility and absorptive capacity are present immediately after operation, the small bowel may be used for feeding. We prospectively evaluated the efficacy of early postoperative jejunal feeding of elemental diet in three groups of patients. Fourteen adults undergoing elective partial colectomy were randomized to receive jejunal feeding of elemental diet (ED) or isotonic intravenous infusions of dextrose (IV). Considering all avenues of nutrition for the first ten postoperative days, seven ED patients received a mean daily input of 2283 calories and 14.1 grams of nitrogen compared to 800 calories and 3.4 grams of nitrogen for the seven IV controls (P less than 0.005). The ED patients lost 2.4 per cent of their body weight during the first postoperative month compared to a 6.1 per cent weight loss for the IV controls (P less than 0.005). The ED group required an intravenous catheter for 1.8 days, compared to 6.6 days for the IV group (P less than 0.005). Twenty consecutive patients subjected to major upper gastrointestinal operations received a daily mean of 1468 calories and 9.7 grams of nitrogen jejunally during the first ten postoperative days. Mean weight loss at two and four weeks postoperatively was 2.8 per cent and 3.5 per cent of preoperative weight. Ten patients received jejunal elemental diet for longer than one month because of postoperative complications or adjunctive therapy for cancer. Mean weight loss was 2.8 per cent. Early postoperative jejunal feeding of elemental diet supplies more nutrients and results in less weight loss than does intravenous therapy with isotonic dextrose. Early postoperative feeding is of value in patients undergoing major operations on the upper gastrointestinal tract.

Adult↗