[Surgery in Vietnam and giant hospitals in Sweden].
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Biomedical subjects
Publications and source records attributed to L Räf.
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To evaluate the contribution of blood cellular elements to inter-organ transport of amino acids, net exchange across the leg and splanchnic bed of 17 amino acids was determined in seven healthy postabsorptive subjects by use of both whole blood and plasma for analysis. Arterial-portal venous differences were measured in five additional subjects undergoing elective cholecystectomy. By use of whole blood, significant net release of amino acids was noted from the leg and gut, while a consistent uptake was observed by the splanchnic bed. The output of alanine from the leg and gut and the uptake of this amino acid by the splanchnic bed exceeded that of all other amino acids and accounted for 35-40% of total amino-acid exchange. Transport by way of plasma could not account for total tissue release or uptake of alanine, threonine, serine, glutamine, methionine, leucine, isoleucine, tyrosine, and citrulline. For each of these amino acids, significant tissue exchange was calculated to occur by way of the blood cellular elements, the direction of which generally paralleled the net shifts occurring in plasma. For alanine, 30% of its output from the leg and gut and 22% of its uptake by the splanchnic area occurred by way of blood cells. We conclude that the blood cellular elements, presumably erythrocytes, contribute substantially to the net flux of amino acids from muscle and gut to liver in normal postabsorptive humans. Alanine predominates in the inter-organ transfer of amino acids occurring by way of blood cells as well as plasma.
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Arterial-venous concentration differences for individual free fatty acids (FFA) were measured across the deep tissues of the forearm, the splanchnic vascular bed, and the kidney in healthy, postabsorptive subjects. In addition, arterial-portal venous FFA differences were determined in five patients undergoing elective cholecystectomy. The differences in fractional uptake among the individual FFA across the forearm were small and not statistically significant. Splanchnic fractional uptake was high for FFA with short chain lengths and rose with increasing degree of unsaturation. Small, negative arterial-portal venous differences for individual FFA were observed, indicating that arterial-hepatic venous FFA differences mainly reflect hepatic uptake. When the arterial FFA concentration was reduced to approximately 25% of the control values by the administration of nicotinic acid, net uptake of total FFA ceased but there was release of stearic acid and uptake of lauric, myristic, and palmitoleic acid to the splanchnic region. Muscle and liver uptakes of individual FFA were both dependent on their arterial concentrations with the exception of the splanchnic uptake of stearic acid. There was no uptake of free arachidonic acid by either muscle or liver, nor was there significant uptake of any of the free fatty acids by the kidney. It is concluded (a) that there are important quantitative differences between the net exchanges of individual FFA across the splanchnic vascular bed, (b) that tracer studies of FFA metabolism require the determination of individual FFA specific activities, (c) that palmitic and oleic acid appear to be suitable tracers for the entire FFA fraction in most instances.
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