Involvement of stem cell factor and its receptor tyrosine kinase c-kit in pain regulation.

The c-kit receptor tyrosine kinase is expressed in a subpopulation of small- and medium-sized neurons of the dorsal root ganglia (DRG) and in the superficial layer of the spinal cord. Stem cell factor (SCF), a ligand of the c-kit receptor, induces neurite outgrowth from DRG and supports the survival of c-kit-expressing neurons. To clarify the possible function of the SCF/c-kit receptor system in the adult animal, we investigated the expression of c-kit receptor in the spinal cord and DRG in relation to pain by using H2C7, a newly developed anti-c-kit monoclonal antibody. S.c. and intrathecal injection of SCF markedly reduced the paw withdrawal threshold to mechanical stimuli and intrathecal SCF at 10 pg maximally induced mechanical allodynia in conscious mice. Intrathecal SCF also reduced the paw withdrawal latency to heat stimuli significantly but transiently. The c-kit receptor was co-expressed in 58.4% of calcitonin gene-related peptide (CGRP) -positive, but only 5.1% of isolectin B4-positive, DRG neurons. In the spinal cord, the c-kit receptor was detected in the superficial layer of the dorsal horn and co-localized there with CGRP in central terminals of DRG neurons. Selective elimination of unmyelinated C-fibers by neonatal capsaicin treatment resulted in marked reduction of the c-kit receptor and CGRP expression in the superficial layer of the spinal cord. Cell-size profiles showed that c-kit receptor expression was significantly up-regulated and down-regulated in medium-sized DRG neurons after neonatal capsaicin treatment and nerve injury, respectively. These results suggest that the c-kit receptor is mainly expressed in peptidergic small-sized DRG neurons and may be involved in pain regulation both peripherally and centrally.

Effect of exercise training and food restriction on endothelium-dependent relaxation in the Otsuka Long-Evans Tokushima Fatty rat, a model of spontaneous NIDDM.

We investigated whether endothelial function may be impaired in the Otsuka Long-Evans Tokushima Fatty (OLETF) rat, a model of spontaneous NIDDM. The effect of exercise training and food restriction on endothelial function was also studied. OLETF rats were divided into three groups at age 16 weeks: sedentary, exercise trained, and food restricted (70% of the food intake of sedentary rats). Otsuka Long-Evans Tokushima rats were used as the age-matched nondiabetic controls. Endothelium-dependent relaxation of the thoracic aorta induced by histamine was significantly attenuated in the sedentary or food-restricted rats, and exercise training improved endothelial function. Relaxation induced by sodium nitroprusside, a donor of nitric oxide, did not differ significantly among groups. Both exercise training and food restriction significantly suppressed plasma levels of glucose and insulin and serum levels of triacylglycerol and cholesterol and reduced the accumulation of abdominal fat. Insulin sensitivity, as measured by the hyperinsulinemic-euglycemic clamp technique, was significantly decreased in sedentary rats but was enhanced in exercise-trained and food-restricted rats. The urinary excretion of nitrite was significantly decreased in sedentary and food-restricted rats compared with nondiabetic rats and was significantly increased in exercise-trained rats. These results indicate that exercise training, but not food restriction, prevents endothelial dysfunction in NIDDM rats, presumably due to the exercise-induced increase in the production of nitric oxide.

Taurine improves insulin sensitivity in the Otsuka Long-Evans Tokushima Fatty rat, a model of spontaneous type 2 diabetes.

BACKGROUND: Taurine, a potent antioxidant, has been reported to improve streptozotocin-induced diabetes mellitus, in which the development of diabetes results from an attack by oxygen free radicals on pancreatic beta cells. However, taurine also increases the excretion of cholesterol via conversion to bile acid and would be expected to improve insulin resistance. OBJECTIVE: The effects of taurine on insulin sensitivity were examined in a model rat of insulin resistance and type 2 diabetes-the Otsuka Long-Evans Tokushima Fatty (OLETF) rat. DESIGN: Male OLETF rats were divided into 2 groups at the age of 16 wk: a taurine-supplemented group and an unsupplemented group. As a nondiabetic control, Long-Evans-Tokushima-Otsuka rats were used. An oral-glucose-tolerance test and hyperinsulinemic euglycemic clamp were performed at the ages of 23 and 25 wk. RESULTS: The OLETF rats had hyperglycemia and insulin resistance and they had a greater accumulation of abdominal fat than did control rats. Abdominal fat accumulation, hyperglycemia, and insulin resistance were significantly lower in the taurine-supplemented group than in the unsupplemented group. Serum and liver concentrations of triacylglycerol and cholesterol were significantly higher in the OLETF rats than in the control rats and were significantly lower in the taurine-supplemented group than in the unsupplemented group, presumably because of the increased secretion of cholesterol into bile acid. Taurine-supplemented rats also showed higher nitric oxide secretion, evidenced by increased urinary excretion of nitrite. CONCLUSION: Taurine effectively improves metabolism in OLETF rats by decreasing serum cholesterol and triacylglycerol, presumably via increased secretion of cholesterol into bile acid and decreased production of cholesterol because of increased nitric oxide production.

Effects of troglitazone on frequency of coronary vasospastic-induced angina pectoris in patients with diabetes mellitus.

This study investigates the effects of troglitazone, an insulin sensitizer, on the clinical manifestation of coronary vasospastic angina pectoris in patients with diabetes mellitus. Troglitazone reduces frequency of angina pectoris and improves endothelial function.

Intracoronary aspiration thrombectomy for acute myocardial infarction.

To investigate the pathogenesis of acute myocardial infarction (AMI) and values of intracoronary aspiration thrombectomy (ICAT), we applied ICAT to reperfusion therapy using generally available intracoronary catheters to aspirate intracoronary occlusive tissues. We assigned ICAT or primary percutaneous transluminal coronary angioplasty (PTCA) to patients with evolving AMI (Thrombolysis In Myocardial Infarction (TIMI) trial grade 0), and investigated primary histopathologic, clinical, and angiographic outcomes in 43 patients treated with ICAT alone or followed by PTCA, and compared the outcomes with those in 48 patients treated with primary PTCA. No major complications (procedural death, emergent bypass graft surgery) occurred. Reconalization (TIMI grade 3 and 2) was achieved in 25 patients (58%) with ICAT alone and in 39 patients (91%) with ICAT alone or followed by PTCA. Aspirated thrombi were defined as recent thrombi in 21 cases (49%), atheroma in 6 (14%), no thrombi in 13 (30%), and organized thrombi in 1 case. In cases of recent thrombi, ICAT alone provided recanalization more frequently than in those of atheroma or no thrombi (18 of 21 [86%], 3 of 6 [50%], 4 of 13 [31%], respectively; p < 0.05; recent thrombi vs atheroma or no thrombi). There were no significant differences in primary recanalization rate (ICAT alone or followed by PTCA vs primary PTCA; 91% vs 92%) or incidence of complications between the 2 strategies. These results indicate that although the pathogenesis of AMI is heterogeneous in each individual case, intracoronary thrombus contributes little to the pathogenesis of average AMI, and therefore mechanical approaches may be feasible to maximize reperfusion therapies for AMI.

Effect of the lipoprotein lipase activator NO-1886 on adriamycin-induced nephrotic syndrome in rats.

Hyperlipidemia associated with nephrotic syndrome may play a role in the deterioration of renal function. Tsutsumi et al have previously reported that the novel compound NO-1886 increases lipoprotein lipase (LPL) activity, resulting in a reduction of plasma triglycerides and an elevation of high-density lipoprotein (HDL) cholesterol in normal rats. The aim of this study was to ascertain whether NO-1886 suppresses the renal injury by treatment of the hyperlipidemia in an Adriamycin (Kyowa Hakko Kogyo, Tokyo, Japan) induced nephrosis rat model fed a high-protein diet that induced renal dysfunction and tubulointerstitial injury. Administration of Adriamycin caused hyperlipidemia, proteinuria, and edema with ascites in rats in 4 weeks. Furthermore, a combination of Adriamycin and a high-protein diet increased plasma creatinine and blood urea nitrogen (BUN) and decreased plasma albumin. Histologically, in Adriamycin-treated rats, marked interstitial cellular infiltration, tubular lumen dilation, and tubular cast formation in the kidney were observed. NO-1886 decreased plasma triglyceride and increased HDL cholesterol in Adriamycin-induced nephrotic rats. NO-1886 treatment reduced plasma creatinine and BUN levels and increased plasma albumin in Adriamycin-treated rats; it also ameliorated the ascites and proteinuria. Histologically, NO-1886-treated rats showed a quantitatively significant preservation of tubulointerstitial lesions. These data suggest that NO-1886 may have a protective effect against Adriamycin-induced nephrosis with tubulointerstitial nephritis in rats by a modification of the plasma lipid disorder.

A lipoprotein lipase activator, NO-1886, improves endothelium-dependent relaxation of rat aorta associated with aging.

Endothelial function is closely related to development of atherosclerosis and is impaired with aging. The novel compound NO-1886, 4-diethoxyphosphorylmethyl-N-(4-bromo-2-cyanophenyl)benzamid e, is a lipoprotein lipase activator and its long term administration protects against the development of experimental atherosclerosis in animals. The aim of this study was to ascertain whether NO-1886 ameliorates the impaired endothelium-dependent relaxation of rat aorta associated with aging. NO-1886 (50 mg/kg p.o.) was administered to 7-month old rats for 3 months. Plasma lipid, glucose and insulin levels in old control rats (10 months of age) were significantly higher than those of young rats (2 months of age). NO- 1886 decreased plasma triglyceride levels (old rats, 233+/-10 mg/dl; old rats + NO-1886, 172+/-16 mg/dl, P < 0.01) and increased plasma high density lipoprotein (HDL) cholesterol level (old rats, 72+/-6 mg/dl; old rats + NO-1886, 142+/-6 mg/dl, P < 0.001) in old rats, but had no effects on plasma glucose or insulin. The endothelium-dependent relaxation of the thoracic aorta caused by histamine was significantly impaired in old rats (% relaxation at 10(-5.5) M histamine: young rats 25.4+/-3.1%; old rats 14.1+/-1.9%, P < 0.01), an effect completely prevented by NO-1886 (old rats + NO-1886; 22.8+/-2.8%, P < 0.05 vs. old rats). In contrast, NO-1886 showed no effect on the endothelium-independent relaxation by sodium nitroprusside. These results indicate that NO-1886 improves impaired endothelium-dependent relaxation of rat aorta associated with aging, possibly by correcting lipid metabolism.

Nitric oxide activates Ca2+-activated K+ channels in cultured bovine adrenal chromaffin cells.

The effects of sodium nitroprusside (SNP) on Ca2+-dependent K+ (KCa) channels in cultured bovine adrenal chromaffin cells were investigated using single channel recording patch-clamp techniques. KCa channels were activated by application of 100 microM SNP to the extracellular side of cell-attached patches. Methylene blue (300 microM), an inhibitor of soluble guanylate cyclase, or H-8 (1 microM), a protein kinase inhibitor with relative specificity for cGMP-dependent protein kinase, diminished but did not completely abolish the SNP-induced KCa channel activation. Diethylamine/NO complex (DEA/NO), an NO donor, also activated KCa channels in cell-attached patches. Furthermore, application of 100 microM SNP or 100 nM DEA/NO to the intracellular surface of excised inside-out patches also activated KCa channels in the bath solution which contained 1 microM Ca2+. These results indicate that SNP is capable of activating the KCa channel via cGMP-dependent and -independent mechanisms. These studies demonstrate that NO may serve as an important regulatory mechanism for catecholamine secretion in chromaffin cells via the activation of KCa channels.

Comparison of physical characteristics, body temperature and basal metabolism between Thai and Japanese in a neutral temperature zone.

The aim of this research is to compare the physical status, basal metabolism and some other physiological characteristics between native Thai in Bangkok, Thailand, and native Japanese in Japan, and discuss the results regarding acclimatization to tropical climate. Measurements of the Thai were made in September in Bangkok, while those of native Japanese were done in August at Nishinomiya (Japan). The subjects were adult males (20-22 years old) in both cases. Physically the Thai are generally a little shorter and more slender than Japanese in the mean value. The mean skinfold thickness for Thai was 8.4 mm, which is significantly less than that of Japanese (11.0 mm). The mean oral temperature measured under basal conditions was the same between both subject groups. The Thai showed a slightly lower basal metabolism per unit body surface, and mean skin temperature measured in a similar environmental condition was lower for Thai than for Japanese. The results of anthropometric measurements and physiological characteristics measured were discussed in view of physiology of acclimatization ot tropical climate.

Angiographic assessment of surgical reconstructions for left ventricular asynergy with indices of abnormally contracting segments.

BACKGROUND: In surgical reconstruction for left ventricular asynergy after myocardial infarction, the conventional linear closure technique second to simple resection and endoventricular circular patch plasty, which is the so-called Dor technique, are commonly utilized. We assessed these techniques using an abnormally contracting segment (ACS) in the left ventriculogram. METHODS: We reviewed 10 and 15 patients who underwent the linear technique (group L) and the Dor technique (group D), respectively. %ACS was determined as the percent ratio of both akinetic and dyskinetic chords among the total chords in the centerline method of regional wall motion analysis. A difference between preoperative and postoperative ejection fraction (EF) was generated by preoperative EF and this percentage ratio was determined as %EF. RESULTS: Postoperative EF improved from 31% to 41% in group L and from 33% to 49% in group D (p<0.05). Postoperative EF in group D was higher than in group L (p<0.05). %ACS decreased from 41% to 34% in group L and from 41% to 19% in group D (p<0.05). Postoperative %ACS was lower in group D than in group L (p<0.05). The significant correlation between preoperative %ACS and %EF was negative in group L and positive in group D (p<0.05). CONCLUSIONS: The Dor technique is more effective for the postoperative systolic function than the linear technique because more extensive reduction in %ACS is possible with the Dor technique than with the linear technique. Dor technique becomes more crucial to the postoperative systolic function as the preoperative %ACS becomes larger.

Effects of dietary level of protein on the maintenance energy requirement and net energetic efficiency for growth of post-weaning rats.

The effects of dietary protein on the maintenance energy requirement (MEm) and net utilization efficiency of metabolizable energy for growth (MEg) were investigated by regression analysis of energy balance with various energy intakes. Weanling rats of the Wistar strain, weighing about 85 g, were given a diet containing 0 to 70% casein freely or in restricted amounts (equivalent to two-thirds or one-third of the intake of the ad libitum group) for 5 days. The MEm was fairly constant in rats given 10 to 50% casein diets, being about 29 kcal/100 g BW/day, but increased at higher or lower dietary protein levels, indicating inefficient energy utilization in protein-malnourished animals. From the slope of the regression line between energy balance and metabolizable energy intake, the net energetic efficiencies for growth were estimated as 68, 71, 74, 77, 82, 83, 80, 78, 77 and 74% with 0, 3, 6, 10, 20, 30, 40, 50, 60 and 70% casein diets, respectively. Weanling rats fed 20 to 30% casein diets utilized the dietary energy for growth most efficiently. At protein levels higher or lower than 20 to 30%, the efficiency was less, showing that MEg utilization depended on dietary protein. The energy necessary for 1 g body weight gain was 2.6 kcal in rats receiving 30% casein diet, but increased with an increase or decrease in the protein level. These data on the food efficiency, MEm, the net efficiency of MEg and the energy necessary for 1 g weight gain show that dietary protein affects energy utilization and that protein-malnourished animals use energy inefficiently.

Maintenance energy requirement in pregnant rats and net energetic efficiency for fetal growth during late pregnancy.

The maintenance energy requirement (MEm) of pregnant rats and net energetic efficiency for fetal growth during late pregnancy were examined by regression analysis. Pregnant rats, weighing about 180 g, were fed on 20% casein diet during early-mid pregnancy and then divided into three groups--ad libitum-fed, 50% food restricted, or starved. A linear relation between the energy balance (Y, kcal/100 g BW/day) and the metabolizable energy intake (X, kcal/100 g BW/day) was obtained as Y = 0.81 X-14.83 (n: 17, r = +0.99, p less than 0.001). The X-intercept, MEm, was calculated to be 18.31 kcal/100 g BW/day. Pregnant animals fed ad libitum retained 6.1 and 1.1 kcal of energy daily in their conceptuses and their own body, respectively, during late pregnancy. Assuming that the net efficiency of maternal energy deposition is equal to that for size- and age-matched nonpregnant rats, the net energetic efficiency for fetal growth was calculated to be 82%. This value was very close to the net efficiency for weanling rats reported previously, suggesting that the net energetic efficiency for maximum growth in well-nourished rats is about 82%.

Obligatory nitrogen losses in pregnant rats with special reference to estimation of net protein utilization.

For estimation of net protein utilization of dietary proteins during pregnancy, obligatory nitrogen losses were measured in protein-deficient rats in which pregnancy was maintained by administration of ovarian steroids. On shift from normal to protein-free diet, urinary nitrogen, expressed as mg/day or mg/100 g BW per day, decreased initially rapidly and then gradually during the first two weeks in both pregnant and nonpregnant rats. However, urinary endogenous nitrogen increased during the final week of pregnancy, whereas it continued to decrease in nonpregnant controls. The endogenous urinary nitrogen excretions during early-mid and late pregnancies were significantly higher in pregnant rats (666 mg/15 days and 234 mg/6 days, respectively) than in nonpregnant animals (585 mg/15 days and 153 mg/6 days, respectively), indicating pregnancy-induced protein hypercatabolism. The metabolic fecal nitrogen excretions in pregnant and nonpregnant rats were comparable. In pregnant rats, a protein-free diet resulted in decrease of basal energy expenditure, from 24 kcal/day on day 1 to about 15 kcal/day on days 16, 19 and 22 of pregnancy. Thus, the ratio of endogenous urinary nitrogen to basal energy expenditure increased in late pregnancy, indicating that "the law of a constant relationship of minimal nitrogen and energy output" is not applicable to the pregnant animals. We discuss which values for obligatory nitrogen loss should be used for estimating the net utilization efficiency of dietary proteins in pregnancy.

Net utilization of various levels of whole egg protein in pregnant rats.

Net protein utilization (NPU) was examined in pregnant rats fed various levels (1, 3, 6, 10 and 20%) of whole egg protein (WEP), based on their obligatory nitrogen losses. On increase in dietary protein, nitrogen balance improved curvilinearly and the NPU decreased exponentially in both pregnant and nonpregnant rats. The utilization efficiency was high in rats fed marginally low protein diets, mainly due to lower urinary nitrogen levels than the obligatory levels of nitrogen loss. The NPUs in pregnant rats fed 1, 3, 6, 10 and 20% WEP diets were 103, 99, 78, 66 and 46, respectively. These values were 15 to 20% higher than those in nonpregnant rats because in pregnant rats obligatory urinary nitrogen loss was higher and the animals took more energy. The problems in application of the NPUs in pregnant rats for estimating the protein allowance of pregnant humans are discussed.

Protein and energy metabolism in patients with progressive muscular dystrophy.

Studies were made on whether body weight loss in patients with muscular dystrophy is due to reduced intake and/or abnormal expenditure of energy. For this, food intakes and various physiological variables were surveyed in totals of 310 patients with Duchenne muscular dystrophy (DMD) of 11 to 29 years old and 28 patients with limb-girdle muscular dystrophy (LGMD) of 30 to 47 years old. Energy and protein intakes, expressed on a unit body weight basis, in DMD patients were comparable to, or higher than the allowances for age-matched healthy controls, whereas those in LGMD patients were 92 and 94% respectively of these allowances. The basal metabolic rate (BMR), expressed as kcal/kg/day, of DMD patients of all ages was higher than that of controls, the difference increasing with age, and being about 20 to 30% higher than that of controls in older patients with DMD. The BMR of LGMD patients was nearly normal. The maintenance requirements of conventional dietary protein in DMD and LGMD patients were 1.26 and 0.84 g/kg/day, respectively. These values were about 68 and 12% higher than the normal adult value (0.75 g/kg/day), indicating decreased protein utilization and increased protein catabolism. Daily excretion of urinary 3-methylhistidine (3MH) per unit muscle mass (micrograms/mg creatinine) by MD patients was significantly higher than that by controls, indicating increased degradation of muscle protein. The BMR, maintenance protein requirement and 3MH excretion of DMD patients suggest that DMD is a hypercatabolic disease. Comparison of the energy and protein intakes with the allowances estimated in consideration of increased requirements showed deficiencies of energy and protein in DMD patients. Thus, we conclude that the underweight of the DMD patients resulted from nutrient deficiencies due to hypercatabolism, despite their considerably high intakes of energy and protein, expressed as per kg body weight. These deficiencies were confirmed by demonstrating decreased concentrations of free essential amino acids, particularly branched chain amino acids, in their serum. The values of variables of LGMD patients were intermediate between those of DMD patients and control subjects.

Predictions of energy intake and energy allowance of patients with Duchenne muscular dystrophy and their validity.

Patients with Duchenne muscular dystrophy are so malnourished that energy supplementation is crucial. Their degree of energy deficiency was assessed as difference between their energy intake and their energy allowance, which were deduced from easily measured parameters. A significant, negative relationship was found between the basal metabolic rate (BMR) (Y, %, BMR/standard BMR) and body weight (X, %, body weight/standard body weight) in the patients, from which the formula for the BMR was deduced to be Y = -1.116X + 174.5 (n = 202, r = -0.72, p less than 0.001). Thus, it is possible to estimate the energy allowance for individual patients by a factorial procedure from the presumed BMR and a factor for physical activity. In addition, their energy intake was calculated from a constant protein-energy % (14.6%) in their diet and nitrogen intake which was deduced from a significant positive correlation between their nitrogen intake (Y, mg/kg/day) and their nitrogen excretion in 24 h urine samples (X, mg/kg/day). This correlation conformed to the equation Y = 1.053X + 32.4 (n = 267, r = +0.76, p less than 0.001). The validities of the above predictions for energy intake and allowance were examined by plotting the degree of energy deficiency (% ratio of presumed intake/presumed allowance) against the concentrations of retinal binding protein, prealbumin and transferrin in the serum, because rapid turnover proteins are sensitive to energy deficiency. Significant positive correlations were obtained with both variables, suggesting that these predictions were valid.

Japanese dietary protein allowance is sufficient for moderate physical exercise in young men.

The sufficiency of the dietary protein allowances recommended by the Ministry of Health and Welfare of Japan for various physical exercises has not been examined. We investigated the protein requirement for moderate-intensity physical exercise using nitrogen balance in the isoenergetic state. Seventeen healthy college students exercised for 10 days with an adaptation period of three days and non-exercise control period of 10 days. They were given a maintenance level of energy and 1.08 g/kg per day of high quality mixed proteins recommended by the Ministry of Health and Welfare of Japan throughout the experimental period. They performed treadmill running during the exercise period at about 65% of VO2max for 25, 41 or 48 min/day, which required 200, 300 or 400 kcal of extra energy, respectively. Although the exercise increased dermal nitrogen loss, urinary nitrogen excretion tended to decrease. Consequently, the exercise ranging from 200 to 400 kcal/day did not significantly alter the nitrogen balance. Thiobarbituric acid-reactive substances and glutathione disulfide were not increased after exercise, suggesting that the moderate exercise, recommended for health promotion by the Ministry of Health and Welfare of Japan, does not cause oxidative damage to healthy subjects. These findings demonstrate that a protein intake of 1.08 g/kg per day is enough for moderate exercise.

Efficiency of utilization of soy protein isolate in Japanese young men.

The nutritional quality of soy protein isolate (SPI) was evaluated in young men by the nitrogen balance method using fish protein as a standard. Twenty-one male university students were given SPI (Supro 620, Ralston Purina Co., St. Louis, Mo., U.S.A.), fish protein (cod fish) or a 50:50 mixture of the two proteins as the sole source of protein. SPI and fish were prepared as paste products (kamaboko). Four experimental periods were used in which each subject received 0.35, 0.45, 0.55 and 0.65 g protein/kg/day, respectively, given in random order. Each period consisted of one day on protein-free diet and ten days on the experimental diet, with an interval of three days on a free-choice (ad libitum) diet between periods. Energy intake was constant for each individual to maintain their body weight (44.6 +/- 2.4 kcal/kg/day). The linear regression equations obtained between nitrogen intake (X: mg N/kg/day) and the apparent nitrogen balance (Y: mg N/kg/day) were as follows: SPI, Y = 0.298X-35.2; fish protein, Y = 0.365X-31.8; mixed protein, Y = 0.423X-38.3. The nitrogen requirement for maintenance of nitrogen equilibrium determined from the regression equation was 118.1 +/- 15.4 mg N/kg/day for SPI, 87.1 +/- 17.2 mg N/kg/day for fish protein and 90.5 +/- 17.1 mg N/kg/day for mixed protein. The NPUs calculated at the respective maintenance nitrogen intakes were 38.9, 52.8 and 50.8 for SPI, fish protein and mixed protein, respectively. There was no significant difference between the nutritive values of mixed protein and fish protein. The nutritive value of SPI relative to fish protein was estimated as 82%, 74% and 74% by the slope-ratio method, and values for the nitrogen requirement and NPU, respectively.

The nutritional status of elderly bed-ridden patients receiving tube feeding.

Long-term enteral feeding by tube has become a frequently used procedure in elderly patients. However, only a few studies dealing with the nutritional assessment of such patients are currently available. This study was designed to clarify this issue. Anthropometric and biochemical variables, energy expenditure and dietary intake were investigated in 44 hospitalized bed-ridden patients with and without tube feeding over 65 years of age and 41 age-matched free-eating elders in a nursing home. All patients with tube feeding received enteral nutrition by nasogastric tube. The body weight, body mass index, mid-upper-arm circumference, arm muscle circumference and serum level of albumin were significantly lower in the patients with and without tube feeding, compared with free-eating elders of both genders (p<0.05). Energy intakes of the patients with tube feeding were 1,171+/-286 kcal/d (about 26 kcal/kg/d), which is comparable to the predicted total energy expenditure (1.2 x basal energy expenditure). Protein intake was 44.9+/-13.1 g/d (about 1.0 g/kg/d) and the percentage of protein per total energy was 15%. These intakes are generally considered to be optimal for bed-ridden patients receiving tube feeding. However, the incidence of protein-malnutrition, as evidenced by decreased arm muscle circumference (<80% of normal) and hypoalbuminemia (<35 g/L), in the patients with tube feeding was significantly higher than that in the healthy elders. In addition, the orally fed bed-ridden patients were also malnourished, suggesting that the bed-ridden patients easily became malnourished even if they were fed energy and protein which approximated calculated predicted values. These findings raise a problem concerning nutritional management of bed-ridden patients.

Relationship between total serum cholesterol level and nutritional and physical status in Nepalese rural people.

To investigate the nutritional condition in a hilly village (Kotyang) and a suburban village (Bhadrakali) in Nepal and to clarify the possible cause of the difference in total serum cholesterol level between the two groups of villagers habitually eating low fat diets, we carried out a nutrition survey using the 24-h recall method and blood sampling in 403 subjects (204 men and 199 women) in the hilly village and 466 (244 men and 222 women) in the suburban village. Total serum cholesterol was statistically significantly lower in the hilly villagers than in the suburban villagers for both sexes, but HDL-cholesterol was not. In both villages, 82% of the total energy was taken from carbohydrate, 7-8% from fat and 10% from protein. Energy, protein, fiber, potassium, magnesium, monounsaturated fatty acid, polyunsaturated fatty acid, and vitamin A in the hilly villagers were significantly higher than those in the suburban villagers. Total serum cholesterol was significantly associated with age and body fat percentage, suggesting that total serum cholesterol level was not directly associated with total fat intake in these Nepalese people.