PubMed Health⌕ Search

Biomedical subjects

R Nezu

Publications and source records attributed to R Nezu.

At least 37 records · Page 2Linked to original sources
PubMed1996

Influence of glutamine-supplemented parenteral nutrition on intestinal amino acid metabolism in rats after small bowel resection.

Glutamine (Gln)-supplemented total parenteral nutrition (TPN) has been shown to improve mucosal adaptation after massive small bowel resection (SBR); however, its influences on intestinal amino acid metabolism remain unknown. In this study, intestinal amino acid flux, circulating plasma aminogram, mucosal glutaminase activity and protein, and DNA content were measured 7 days after massive SBR in rats receiving either standard (Std) or Gln-supplemented TPN. Sham-operated rats and rats fed chow after enterectomy served as controls. The uptake of Gln and the release of citrulline (Cit) by the remaining intestine was significantly decreased, with reduced mucosal glutaminase activity after SBR in the Chow and Std-TPN groups. Glutamine supplementation resulted in significantly increased gut Gln uptake compared with Std-TPN (P < 0.01). Mucosal glutaminase activity, mucosal protein, and DNA content was also increased by Gln; however, the gut release of Cit remained unchanged (P > 0.05). The subsequent decrease in circulating arginine (Arg) in the Gln-TPN group compared with the Std-TPN group (P < 0.05) was attributed to an insufficient exogenous supply. These findings show that Gln-supplemented TPN improves mucosal growth and gut Gln uptake after SBR. However, the intestinal production of Cit, which remained low in both TPN groups, may lead to an insufficiency of endogenous Arg synthesis. Thus, both Gln and Arg may be essential amino acids after SBR.

Amino Acids↗
PubMed1996

Intraoperative manometry during laparoscopic operation for esophageal achalasia: does pneumoperitoneum affect manometry?

The effects of pneumoperitoneum on the lower esophageal sphincter (LES) were evaluated during laparoscopic operation for esophageal achalasia. Intraoperative manometry was performed in three patients who underwent laparoscopic cardiomyectomy with Dor's fundoplication and five patients who underwent laparoscopic cholecystectomy (LC). The LES pressure and the length of the high-pressure zone (HPZ) did not change during pneumoperitoneum in either the achalasia and the LC group. In the achalasia group the LES pressure was sufficiently decreased following completion of cardiomyectomy, and the length of the HPZ was found to be sufficiently long after completion of fundoplication. The postoperative courses of the achalasia patients were uneventful, and they have had no symptoms of achalasia or gastroesophageal reflux since the operation. Accordingly, intraoperative manometry during 12 mmHg pneumoperitoneum was considered to be available for laparoscopic surgery for esophageal achalasia.

Adult↗
PubMed1996

Alanyl-glutamine dipeptide-supplemented parenteral nutrition improves intestinal metabolism and prevents increased permeability in rats.

OBJECTIVE: The authors determined the effects of alanyl-glutamine-supplemented total parenteral nutrition (TPN) on mucosal metabolism, integrity, and permeability of the small intestine in rats. METHODS: Male Sprague-Dawley rats were randomized to receive TPN supplemented with a conventional amino acids mixture (STD group) or the same solution supplemented with alanyl-glutamine; both solutions were isocaloric and isonitrogenous. On the seventh day of TPN, D-xylose and fluorescein isothiocyanate (FITC)-dextran were administered orally. One hour later, superior mesenteric vein (SMV) D-xylose and plasma FITC-dextran concentration were measured. Intestinal blood flow and calculated intestinal substrates flux were measured with ultrasonic transit time flowmetery. RESULTS: Plasma FITC-dextran increased significantly in the STD group. Intestinal blood flow and SMV D-xylose concentration did not differ between the groups. Mucosa weight, villus height, mucosal wall thickness, mucosal protein, and DNA and RNA content in jejunal mucosa were significantly increased in the alanyl-glutamine group. Jejunal mucosal glutaminase activity and net intestinal uptake of glutamine (glutamine flux) were significantly higher in the alanyl-glutamine group as compared with the STD group. CONCLUSION: Addition of alanyl-glutamine dipeptide to the TPN solution improves intestinal glutamine metabolism and prevents mucosal atrophy and deterioration of permeability.

Animals↗
PubMed1996

Quantification of intestinal blood flow by ultrasonic transit time flowmetry in fed and endotoxaemic rats.

OBJECTIVE: To compare the dye dilution method with ultrasonic transit time flowmetry (UTTF) for quantifying intestinal blood flow in the same experimental animals. DESIGN: Open experimental study. SETTING: University hospital, Osaka, Japan. MATERIAL: 11 (experiment 1) and 25 (experiment 2) adult male Sprague-Dawley rats. INTERVENTIONS: In experiment 1, the rats were fasted overnight. In experiment 2, endotoxin, Escherichia coli lipopolysaccharide (endotoxin) or saline (sham) was injected intraperitoneally. MAIN OUTCOME MEASURES: Superior mesenteric venous and abdominal aortic blood flow. RESULTS: Experiment 1: intestinal blood flow measured by UTTF was significantly decreased by 17% (p < 0.05) and 56% (p < 0.05) after 30 minutes infusion through the tertiary branch of the mesenteric vein and during simultaneous drawing of blood samples from both the carotid artery and the superior mesenteric vein over a 1.5 minute period, respectively. The intestinal blood flow measurements obtained by UTTF at different intervals before simultaneous drawing of blood from the carotid artery and the superior mesenteric vein differed significantly (p < 0.05) from those obtained by the dye dilution method. Experiment 2: intestinal blood flow was also decreased by 21%-34% (p < 0.05) during similar simultaneous drawing of blood. Aortic blood flow in the endotoxin group was reduced by 66% (p < 0.05) compared with fed animals and 63% (p < 0.05) compared with sham animals. Simultaneously, intestinal blood flow in the endotoxin group was also reduced by 57% (p < 0.05) compared with fed or 48% (p < 0.05) compared with sham treated animals. CONCLUSION: Real intestinal blood flow might not be measured by the procedure of simultaneously drawing blood from the carotid artery and the superior mesenteric vein in rats as is usually done in the dye dilution method. Intraperitoneal endotoxin reduced aortic as well as intestinal blood flow. We propose that UTTF is an alternative method for quantifying intestinal blood flow in fed and endotoxaemic animals.

Animals↗
PubMed1995

Rapid turnover proteins as a prognostic indicator in cancer patients.

We investigated the relation between the plasma levels of various proteins, especially rapid turnover proteins (RTPs), and the prognosis in advanced cancer patients receiving total parenteral nutrition (TPN). In the patients with benign disease (n = 40), RTPs increased abruptly following TPN, but in patients with malignant disease, they rose slowly. Patients with malignant disease were divided into two different groups according to the outcome; group A, surviving 3 months or more after TPN and group B, who died within 3 months after TPN initiation. Whereas the RTP levels were elevated significantly in group A, they did not show any noticeable increase in group B. There was a close correlation between the plasma protein levels at 2 weeks and the survival time after TPN initiation. Thus, using the estimated critical values of RTPs with prognostic significance, the correct prognosis rate in 37 newly treated cases was: transferrin 75.7%, prealbumin: 91.9%, retinol-binding protein: 86.5%. These results clearly indicate that the TPN-induced changes in RTPs, notably in the PA value, can be a good prognostic indicator of survival in advanced cancer patients.

Adult↗
PubMed1994

The effect of donor-specific transfusion and cyclosporin A on small bowel transplantation in the rat.

Pre-transplant blood transfusions are given as a means of desensitization to reduce the required dose of cyclosporin A (CsA). In this study, the effect of pretransplant blood transfusion on host survival and T-cell function against alloantigen were investigated. Male Lewis rats (RT1(1)) were used as the recipients in all experiments, and male DA rats (RT1a) were used as the blood and small bowel donors, and as a source of allogeneic stimulator cells. Male BUF rats (RT1b) were used as donors of third party blood, and of allo-stimulator cells in a delayed-type hypersensitivity (DTH) response. In our experimental design, Lewis rats were divided into the following groups according to the type of administration: (1) a donor-specific blood transfusion (DST) 8 days preoperatively and a concurrent 5-day course of CsA at 10 mg/kg per day; (2) a nonspecific third party blood transfusion (NST) and CsA at 10 mg/kg per day from day 8 to day 4 preoperatively; (3) CsA alone from day 8 to day 4 preoperatively; (4) DST alone 8 days preoperatively; or (5) no treatment, being the control group. Postoperative treatment consisted of CsA at 2.5 mg/kg per day for 30 days. Rats conditioned with NST plus CsA, CsA alone, DST alone, and the untreated control rats survived for 7.2 +/- 1.2, 9.0 +/- 2.2, 6.8 +/- 0.4, and 7.4 +/- 1.6 days, respectively. In contrast, the five rats conditioned with DST plus CsA survived for 100 days or more.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Effect of amino acids in total parenteral nutrition on cholestasis in newborn rabbits.

The effect of amino acids on total parenteral nutrition (TPN)-associated cholestasis was examined using a newborn rabbit TPN model. Twenty-nine newborn Japanese white rabbits were divided into four groups. Group I received a TPN solution with composition and total energy similar to that of rabbit breast milk. Group II received more dextrose than group I. Group III received a larger amount of amino acids than group II. Group IV was nourished by lactating mothers. After 7 days of TPN, blood samples and liver specimens were obtained. In group II, the serum total bilirubin level (1.44 +/- 0.68 mg/dL) was significantly higher than normal (0.28 +/- 0.07 mg/dL) and that of group I (0.49 +/- 0.12 mg/dL). In group II, histological cholestasis was present, characterized by bile plugs in bile ducts, bile pigments in Kupffer cells and hepatocytes, and nonprotein calorie overload changes in clear cell transformation of the hepatocytes. In group III, the serum total bilirubin level (0.23 +/- 0.05 mg/dL) was normal, and there were minimal cholestatic and nonprotein calorie overload changes (histologically) in the liver. These results indicate that cholestasis in this study was induced by nonprotein calorie overload and was prevented by an appropriate volume of amino acids.

Amino Acids↗
PubMed1994

[Role of malnutrition on immunity].

Although the relationship between starvation and reduced resistance to infection has been suggested by historical accounts of famines and pestilence and by recent epidemiologic studies, the concept of nutritional deficiency causing impairment of immunocompetence is relatively recent. In PEM (protein-energy malnutrition), most of the host defence mechanisms are breached, especially manifested in reduced cell-mediated immunity. One plausible reason is the reduction in mature fully differentiated T lymphocytes. Recent immunological methods made it possible to analyze its precise mechanism and process in detail. Naturally occurring states of malnutrition are difficult to interpret largely because deficiencies usually involve multiple dietary factors. It is obvious that single nutrients can only be analyzed in defined and controlled animal experiments. Role of micronutrients such as zinc, iron, and vitamins, specific amino acids such as arginine, glutamine, and fat on immunological responses have been paid attention on their specific actions and some of them have been investigated in humans as well.

Antibody Formation↗
PubMed1992

Zinc-deficient diet impairs adaptive changes in the remaining intestine after massive small bowel resection in the rat.

An investigation was conducted on the influence of the presence of zinc in an elemental diet on the mucosa of residual intestine after massive small bowel resection. A total of 34 male Sprague-Dawley rats were divided into five groups: control animals (n = 10) were killed after overnight fasting; a second group (n = 14) underwent massive small bowel resection preserving 10 cm of terminal ileum, and the third group (n = 10) underwent sham operation. Animals in the second and third groups were fed either a commercially available elemental diet or a zinc-deficient diet for 2 weeks; they were then killed. In animals receiving the zinc-deficient diet, a significant decrease (P < 0.05) was noted in plasma zinc and total protein, and in mucosal wet weight (duodenum), thickness (duodenum and ileum), and protein (duodenum) and DNA (duodenum) content. Mucosal sucrase and maltase specific activities in the duodenum and ileum fell but diamine oxidase levels did not. These results suggest that zinc plays an important role in intestinal adaptation in the rat, and indicate that this trace element is essential for intestinal mucosal preservation in this animal.

Adaptation, Physiological↗
PubMed1992

Massive small bowel resection in neonates--is weaning from parenteral nutrition the final goal?

Eight surviving cases from an original 15 pediatric patients who underwent massive small bowel resection during their neonatal period were reviewed for a period of 2-19 years to assess long-term prognosis. the primary diseases were congenital intestinal atresia in 6 cases and midgut volvulus in 2. The length of the residual small intestine ranged from 27-75 cm and the ileocaecal valve had been resected in 3 cases. All cases were able to be weaned from parenteral nutrition and at present, 6 of the children can tolerate normal meals but 2 are still receiving enteral nutrition, in the form of a low residue diet at home. Near normal somatic growth was achieved in the most recent 5 cases who received intensive nutritional treatment in the immediate postoperative period, whereas 3 who did not receive nutritional management exhibited growth retardation. The D-Xylose absorption test revealed gradual improvement and finally normal absorption in all except one case with the shortest remaining intestine (27 cm). However, the fat absorption test revealed abnormal absorption in cases with a residual intestine of less than 45 cm. Late metabolic complications such as renal calculi, cholelithiasis and pathologic fractures were encountered in 3 cases.

Child↗
PubMed1992

Role of zinc in surgical nutrition.

Redistribution of zinc in tissues was induced during zinc-free TPN in PEM, and a marked decrease in skin zinc level may contribute to skin lesions and to impaired wound healing in skin. And clinical studies suggest that plasma zinc level is one of the sensitive markers for stress following surgery.

Humans↗
PubMed1990

Zinc in clinical surgery--a research review.

Among the essential trace elements in mammals, zinc is somewhat unique in that it is a constituent of numerous metallo-enzymes having biologic significance in many respects. The discovery of zinc deficiency in man induced the remarkable progress of studies on its physiology and it is now recognized that zinc deficiency manifests itself differently in different areas of clinical medicine. It also appears reasonable to say that no trace elements have been more closely related to surgery than zinc. We discuss herein, its significance, implications and role in such areas as; (1) wound healing: where the usefulness of zinc for promoting wound healing in the presence of low plasma zinc levels has been firmly established; (2) total parenteral nutrition (TPN); zinc free TPN may cause skin eruptions associated with abdominal symptoms presenting a picture closely resembling that of acrodermatitis enteropathica; (3) specific pathological conditions: patients with Crohn's disease and other benign diseases accompanied by mal-digestion or -absorbtion are often predisposed to zinc deficiency, similar to those manifesting clinical signs in the early stage of TPN; and (4) surgical stress: which triggers the release of various mediators, possibly increasing hepatic zinc deposition and decreasing plasma and skin zinc levels.

Humans↗
PubMed1990

The effect of metronidazole on TPN-associated liver dysfunction in neonates.

The effect of metronidazole (MNZ) on hepatic dysfunction associated with total parenteral nutrition (TPN) in neonates was investigated. Neonates receiving TPN for more than 2 weeks were divided into three groups. In group 1, TPN was given alone, in group 2, 25 mg/kg/d of MNZ was administered intravenously for the first 2 weeks of TPN, and in group 3, 50 mg/kg/d of MNZ was given for the first 3 weeks of TPN. Several parameters of liver function tests (LFTs) during the first 4 weeks of TPN were compared among these three groups. There was no significant difference of these parameters between group 1 and group 2. Although there was no significant difference of alkaline phosphatase, gamma-glutamyl transpeptidase, direct bilirubin, and total bile acid between groups 1 and 3, transaminase (glutamic oxaloacetic, glutamic pyruvic) of group 3 remained significantly lower than those of group 1. In conclusion, the administration of MNZ 50 mg/kg/d for 3 weeks, at least, prevented the elevation of transaminase during TPN in neonates, suggesting the possible involvement of intestinal anaerobic flora in the pathogenesis of TPN-associated liver dysfunction.

Cholestasis, Intrahepatic↗
PubMed1986

[Hyperbilirubinemia in neonates associated with total parenteral nutrition].

Clinical studies on the pathogenesis of hyperbilirubinemia (HB) in neonates during total parenteral nutrition (TPN) were performed. From 1971 to 1982, 77 neonates underwent TPN for more than 2 weeks in our institutions. Forty-four of them (57.2%) developed HB during the first one month of life. Twenty eight of 32 patients (87.5%) with dominant infection developed hB, while only 16 of 45 (35.6%) without infection developed HB. Patients with any kind of obstructive intestinal diseases evoked HB more commonly than patients with other diseases. In addition, HB occurred more often in the patients receiving more than 110 kcal/kg/day than those receiving less than that. Gestational ages, birth weights, the duration of TPN and fasting periods had no significant influence on the occurrence of HB.

Age Factors↗