Protein and energy intake of adult hospitalized patients.
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Biomedical subjects
Publications and source records attributed to V Tanphaichitr.
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A 16-year-old male with severe metabolic acidosis required huge doses of sodium bicarbonate to alleviate his symptoms. Subsequent investigation showed that his bone marrow and kidneys were infiltrated with myelomonoblasts. His clinical course showed a temporal relationship between acute myelomonoblastic leukemia and metabolic acidosis. The literature on various etiologies of metabolic acidosis is reviewed. This is probably the first documented case of acute leukemia with the simultaneous occurrence of renal tubular, lactic and ketoacidoses.
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Plasma carnitine and urinary carnitine levels were measured in Thai adults living in Bangkok city and Ubol villages. The mean plasma carnitine and urinary carnitine levels expressed in micromoles per liter in Bangkok adults were higher than those in Ubol adults. Their mean plasma carnitine levels were 56.6 +/- 1.8 and 50.3 +/- 1.7 whereas urinary carnitine levels were 161 +/- 19 and 127 +/- 18 micromole/liter, respectively. The nutritional status in Ubol adults was inadequate. This was evidenced by the significant decrease in urinary creatinine excretion, serum albumin, and hematocrit levels. The dietary assessment agreed with the biochemical findings. Since rice, limiting in carnitine, was the main protein and energy source consumed by Ubol adults their inadequate carnitine status could be due to the low carnitine intake. Sex affects plasma carnitine levels in Bangkok adults and urinary carnitine excretion in both groups. This could be related to the lean body mass in which most of the body carnitine resides. This is supported by the higher urinary creatinine excretion in males and the significant positive correlation between carnitine excretion and creatinine-height index.
140 adult hospitalized Thai patients were assessed for their nutritional status. The prevalence of protein-calorie malnutrition in these patients based on various parameters was as follows: 73.2% according to weight-height, 80.0% accroding to triceps skinfold thickness, 60.7% according to upper arm muscle circumference, 50.4% according to hair root morphology and 66.2% according to serum albumin level. These data reflected the disproportionate loss of the patients' body tissues. Severity of protein-calorie malnutrition was also detected by physical signs. Anemia and vitamin deficiencies were present in some of the patients. This study signifies that intensive nutritional management should be done to combat hospital malnutrition.
Activities of carnitine acetyltransferase (CAT) were determined in fertile (greater than 40 X 10(6) sperm/ml) and oligospermic infertile semen (less than 15 X 10(6) sperm/ml). CAT specific activities (unit/10(6) sperm) appear to be similar in both kinds of semen i.e., 0.020 +/- 0.002 and 0.013 +/- 0.001 for fertile and oligospermic infertile sperm, respectively. When CAT activities were corrected as unit/mg protein and unit/mg DNA, the values in the fertile sperm were 0.130 +/- 0.010 and 8.97 +/- 0.50, respectively, while in the infertile sperm the values were 0.016 +/- 0.002 and 2.72 +/- 0.14. The lower value in the oligospermic infertile sperm is due to the much higher amount of these macromolecules in infertile sperm. On the other hand, CAT activities and the amount of protein appear to be similar in both fertile and oligospermic seminal plasma. Our results, therefore, suggest that the lower level of CAT in infertile semen is due to its lower sperm density.
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The level of total L-carnitine was determined in normal human seminal plasma and sperm. Most of the L-carnitine is concentrated in the seminal plasma and its level is about 10 times higher than that in blood plasma. About 50% of total L-carnitine in normal human seminal plasma exists in the form of acetylcarnitine. Similar studies were also carried out in oligospermic and azoospermic human seminal plasma. The level of L-O-acetylcarnitine in both types of infertile samples is significantly lower than that in normal samples. On the other hand, the level of free L-carnitine is the same in fertile and infertile seminal plasma.
Male weanling rats were fed a 72% rice diet containing no detectable carnitine and limiting in threonine and lysine. Such dietary conditions may simulate protein malnutrition in man. Under these conditions growth impairment, anemia, hypoproteinemia, and fatty liver developed. The study focused principally on the fatty liver syndrome which was corrected to varying extents depending on degrees of supplementation with carnitine, lysine, threonine, and appropriate combinations of these nutrients. Such reduction in fatty liver accumulation was accounted for principally by the lowering of triglycerides, but also in part of total cholesterol levels. All the data, which also included monitoring carnitine uptake by the tissues and measurement of plasma triglycerides, were consistent with the view that fatty liver accumulation occurs in amino acid deficient diets because (a) of an impairment in the synthesis of the lipoprotein complex mandatory for triglyceride secretion from the liver and (b) from a deficiency of carnitine needed for the intramitochondrial transport of fatty acids prerequisite for their oxidation.
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