Intestinal absorption and lymphatic transport of eicosapentaenoic (EPA), docosahexaenoic (DHA), and decanoic acids: dependence on intramolecular triacylglycerol structure.

We compared the absorption of eicosapentaenoic (EPA, 20:5n-3), docosahexaenoic (DHA, 22:6n-3), and decanoic acids in mesenteric lymph duct-cannulated rats following intragastric administration of two oils with different intramolecular triacylglycerol structures. One oil had a specific triacylglycerol structure with EPA and DHA located in the sn-2 position and decanoic acid in the sn-1 and sn-3 positions (specific M-n3-M) whereas the other oil had a random fatty acid distribution (random M-n3-M). The mol% (mol/100 mol total fatty acids) of fatty acids in the two oils was similar, with approximately 66 mol% of decanoic acid and 22 mol% of EPA and DHA. The lymphatic transport (microgram/min) of EPA and DHA as well as the mol% in the total lymph lipids were significantly (both P < 0.01) increased following intragastric administration of specific M-n3-M compared with random M-n3-M. The mol% of decanoic acid in the total lymph lipids was significantly (P < 0.01) higher after random M-n3-M compared with specific M-n3-M but the transport (microgram/min) of decanoic acid was not significantly different. We conclude that under our experimental conditions specific M-n3-M with EPA and DHA predominantly in the sn-2 position of the triacylglycerols was a more readily absorbed source of EPA and DHA and in this context should be investigated further for the potential use in clinical nutrition.

Effects of butter oil blends with increased concentrations of stearic, oleic and linolenic acid on blood lipids in young adults.

OBJECTIVE: The aim of this present project was to evaluate a more satisfactory effect on plasma lipoprotein profile of spreads based on dairy fat. DESIGN: This study was designed as a randomised cross-over experiment with a three-week treatment separated by a three-week wash-out period. Sixty five grams of the fat content of the habitual diets was replaced by either butter/grapeseed oil (90:10) (BG); butter oil and low erucic rapeseed oil (65:35) (BR) or butter blended in a 1:1 ratio with a interesterified mixture of rapeseed oil and fully hydrogenated rapeseed oil (70: 30) (BS). SUBJECTS: Thirteen healthy free-living young men (age 21-26 y) fulfilled the study. INTERVENTIONS: At the beginning and end of each diet period two venous blood samples were collected. Triacylglycerol and cholesterol concentrations in total plasma and VLDL, LDL, IDL and HDL fractions were measured, as were apo A-1 and apo B concentrations. Fatty acid composition of plasma phospholipids, plasma cholesterol ester and platelets was also determined. RESULTS: Significantly (P < 0.05) lower total and LDL-cholesterol concentrations were observed after the BR and BS period, compared to BG. The effect of BR and BS did not differ. BG and BR resulted in equal concentrations of HDL-C, but significantly higher than BS. Consequently, a significantly lower LDL-C/HDL-C ratio was seen after the BR treatment compared to BG and BS. Apo A-1 concentrations were not significantly different, but Apo B was significantly increased after BG. CONCLUSIONS: Partially replacing milk fat with rapeseed oil seems to yield a more healthy spread. Stearic acid had a HDL-C lowering effect compared to milk fat, but did not affect LDL-C significantly. The addition of stearic acid did not improve the plasma lipoprotein profile for young men with low cholesterol levels.

Immunotherapy in multiple sclerosis, Part 2.

The efficacies of corticosteroids and azathioprine (part 1) and of cyclophosphamide, immune globulin, cyclosporine, interferons, copolymer 1, and cladribine (part 2) in patients with multiple sclerosis (MS) are reviewed. MS is an inflammatory, demyelinating disease of the CNS that commonly affects young adults. The involvement of various immune mechanisms in MS suggests a role for immunomodulating therapy. The goals of immunotherapy vary with the clinical stage of the disease and include (1) improving recovery from exacerbations, (2) decreasing the number or severity of relapses, (3) preventing the development of chronic progressive disease from a relapsing-remitting course, and (4) decreasing further progression in patients with chronic progressive disease. In clinical trials, corticotropin and corticosteroids have been found to accelerate recovery from exacerbations. Tapering is often effective after high-dose induction therapy. Long-term maintenance regimens do not alter disease progression and are not recommended. Azathioprine produces modest benefits with respect to relapse rates and disease progression after two or more years of treatment; adverse effects are mild to moderate. Azathioprine should not be used in patients with aggressive disease who may approach severe disability in 6-18 months. Cyclophosphamide, because of its modest impact on disease progression and its potentially severe adverse effects, including cancer, should be reserved for patients with aggressive relapsing-remitting or chronic progressive disease in whom other treatments have failed to work; maintenance therapy is necessary after induction. Intravenous immune globulin may benefit patients with severe relapses; however, its efficacy remains unproven. Cyclosporine also cannot be recommended because of its modest efficacy, marked adverse effects, and high cost. Interferon beta-1b is a more specific immunotherapy that has been found to decrease the number and severity of relapses. This treatment should be considered in patients with relapsing-remitting disease who are having two or more exacerbations per year. Copolymer 1 and cladribine have shown some promising early results. Although various immunotherapeutic drugs can provide relief in patients with MS, none is capable of reversing disease progression, and some can cause serious adverse effects. Better understanding of the immunologic basis of MS may lead to more specific immunotherapies with more lasting benefits.

Immunotherapy in multiple sclerosis, Part 1.

The efficacies of corticosteroids and azathioprine (part 1) and of cyclophosphamide, immune globulin, cyclosporine, interferons, copolymer 1, and cladribine (part 2) in patients with multiple sclerosis (MS) are reviewed. MS is an inflammatory, demyelinating disease of the CNS that commonly affects young adults. The involvement of various immune mechanisms in MS suggests a role for immunomodulating therapy. The goals of immunotherapy vary with the clinical stage of the disease and include (1) improving recovery from exacerbations, (2) decreasing the number or severity of relapses, (3) preventing the development of chronic progressive disease from a relapsing-remitting course, and (4) decreasing further progression in patients with chronic progressive disease. In clinical trials, corticotropin and corticosteroids have been found to accelerate recovery from exacerbations. Tapering is often effective after high-dose induction therapy. Long-term maintenance regimens do not alter disease progression and are not recommended. Azathioprine produces modest benefits with respect to relapse rates and disease progression after two or more years of treatment; adverse effects are mild to moderate. Azathioprine should not be used in patients with aggressive disease who may approach severe disability in 6-18 months. Cyclophosphamide, because of its modest impact on disease progression and its potentially severe adverse effects, including cancer, should be reserved for patients with aggressive relapsing-remitting or chronic progressive disease in whom other treatments have failed to work; maintenance therapy is necessary after induction. Intravenous immune globulin may benefit patients with severe relapses; however, its efficacy remains unproven. Cyclosporine also cannot be recommended because of its modest efficacy, marked adverse effects, and high cost. Interferon beta-1b is a more specific immunotherapy that has been found to decrease the number and severity of relapses. This treatment should be considered in patients with relapsing-remitting disease who are having two or more exacerbations per year. Copolymer 1 and cladribine have shown some promising early results. Although various immunotherapeutic drugs can provide relief in patients with MS, none is capable of reversing disease progression, and some can cause serious adverse effects. Better understanding of the immunologic basis of MS may lead to more specific immunotherapies with more lasting benefits.

Semiquantitative cultures and routine tip cultures on umbilical catheters.

One hundred and fourteen umbilical catheters (79 arterial and 35 venous) were cultured with a semiquantitative technique. Twelve cultures were SQC positive with greater than or equal to 15 colonies, and all but two of these had greater than or equal to 100 colonies. Organisms usually considered to be pathogens were associated with SQC positive catheters, whereas organisms generally considered nonpathogens were associated with less than 15 colonies on SQC. Therefore SQC may help to differentiate between contamination and infection related to umbilical catheters. The one case with purulence at the cord base grew 100 colonies of Staphylococcus epidermidis on SQC. S. epidermidis showed a bimodal distribution in colony count and should be considered as a pathogen when high colony counts are present. Duration of catheterization was longer in SQC positive catheters. Empiric antibiotic use was associated with negative SQC. Further study is indicated in a newborn population with a lower rate to antibiotic use for correlation of SQC results with catheter-induced bacteremia and sepsis.