[Primary intestinal lymphangiectasia (Waldmann's disease)]. / Lymphangiectasies intestinales primitives (maladie de Waldmann).

Primary intestinal lymphangiectasia (PIL), Waldmann's disease, is a rare disorder of unknown etiology characterized by dilated intestinal lacteals leading to lymph leakage into the small-bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. PIL is generally diagnosed before 3 years of age but may be diagnosed in older patients. The main symptom is bilateral lower limb edema. Edema may be moderate to severe including pleural effusion, pericarditis or ascites. Protein-losing enteropathy is confirmed by the elevated 24-h stool α1-antitrypsin clearance and diagnosis by endoscopic observation of intestinal lymphangiectasia with the corresponding histology of biopsies. Videocapsule endoscopy may be useful when endoscopic findings are not contributive. Several B-cell lymphomas of the gastrointestinal tract or with extra-intestinal localizations were reported in PIL patients. A long-term strictly low-fat diet associated with medium-chain triglyceride and liposoluble vitamin supplementation is the cornerstone of PIL medical management. Octreotide, a somatostatin analog, have been proposed with an inconsistent efficacy in association with diet. Surgical small-bowel resection is useful in the rare cases with segmental and localized intestinal lymphangiectasia. A prolonged clinical and biological follow-up is recommended.

Effect of soluble or partly soluble dietary fibres supplementation on absorption and balance of calcium, magnesium, iron and zinc in healthy young men.

OBJECTIVES: This study is aimed at investigating the effect of feeding a soluble or partly soluble fibre rich-diet on the apparent absorption and balance of calcium, magnesium, iron and zinc in healthy young men, by using a chemical balance technique. STUDY DESIGN: Nine healthy young men were given a control diet or the same diet complemented with either inulin (soluble) or sugar beet fibre (partly soluble) during 28 d periods according to a 3 x 3 latin square design with three repetitions. During the 20 d adaptation period to fibre ingestion, experimental fibres were incorporated into bread (60%) and liquid foods (40%) up to a maximum of 40 g/d. Ca, Mg, Fe and Zn were measured in diets and in a 8 d urine and faecal composites to assess mineral absorption and balance. RESULTS: The dietary mineral intake provided (mg/d) 859 +/- 196 of Ca; 311 +/- 43 of Mg; 11.6 +/- 1.7 of Fe; and 11.1 +/- 1.6 of Zn from the control diet. The apparent absorption of minerals from the control diet was (%) Ca: 21.3 +/- 12.5; Mg: 46.3 +/- 10.9; Fe: 21.8 +/- 12.3 and Zn: 14.0 +/- 14.5 (mean +/- s.d.). Ingestion of inulin significantly increased the apparent absorption and the balance of Ca. Sugar beet fibre ingestion resulted in a significant increase in Ca intake and balance, without modification its apparent absorption. Apparent absorption and balance of Mg, Fe and Zn were not significantly altered by the ingestion of either experimental fibre. CONCLUSIONS: Addition of the two experimental fibres (inulin or sugar beet fibre) to normal mixed diets can improve Ca balance without adverse effects on other mineral retention. SPONSORSHIP: This project was supported by the French Ministry of Agriculture, Fisheries and Foods (programme Aliment #2002-Aliment Demain; No. 906335). The authors acknowledge the société Agro Industries, Recherche et Developpement (Mr R. De Baynast) who supplied them with the experimental fibres.

Diets deficient in selenium and vitamin E affect plasma lipoprotein and apolipoprotein concentrations in the rat.

The present study examined the effects of Se, vitamin E and combined Se and vitamin E deficiencies in rats on plasma lipid, lipoprotein and apolipoprotein (apo) concentrations. Deficiencies were induced by feeding rats the respective diets for 6 weeks. The study shows that Se deficiency results in increased concentrations of plasma cholesterol and apo E. Both could be explained by an increase in the HDL1 fraction. Vitamin E deficiency alone had no significant effect on plasma lipid, lipoprotein and apo concentrations. Se deficiency in combination with vitamin E deficiency leads to an increase in plasma LDL and apo B concentrations. These results point to the need for further investigations on the mechanism by which Se deficiency affects lipoprotein metabolism.

Adaptation of a dry ashing procedure for determination of selenium by fluorimetry in high-fat foods.

The wet ashing-dry ashing procedure for destruction of organic matter in high-fat foods for subsequent fluorimetric determination of selenium was investigated. Samples were decomposed by predigestion with nitric acid and dry-ashed with magnesium nitrate and hydrochloric acid. Selenium was recovered quantitatively through the total procedure. Detection limit was about 4 ppb. Accuracy was tested by analysis of several reference materials and by comparison with the wet-digestion method. The present method can be used conveniently for selenium determination in high-fat foods.

[Nutritional biological markers of deficiencies of zinc, copper and selenium]. / Marqueurs biologiques nutritionnels des carences en zinc, cuivre et sélénium.

Direct and indirect indices used for the assessment of copper, zinc or selenium status in humans are reviewed. Variations, advantages and disadvantages are discussed. Despite the numerous indices, none of them provide a satisfactory assessment of the nutritional status for these trace elements. The best indices are probably serum zinc and alkaline phosphatase for the assessment of zinc status, serum selenium for the assessment of selenium status and possibly erythrocyte Cu-Zn superoxide dismutase for the assessment of copper status.

[Concentration of zinc, copper, selenium and aluminium in nutritive solutions for parenteral administration]. / Concentration de Zn, Cu, Se et Al dans des solutés nutritifs utilisés par voie parentérale.

Total parenteral nutrition (TNP) therapy is widely used. However the quantitative requirements or the toxicity of trace elements in parenteral solutions are difficult to assess. This paper deals with a study performed by the Trace Element Commission of the Société Française de Biologie Clinique. Trace metals (zinc, copper, selenium and aluminium) which are mainly involved in TPN solutions are analyzed in 12 different parenteral nutrition solutions commercially available. This multicentric assay (5 different sites of analysis) shows that a slight pollution can be noted for nearly all the solutions examined. But at this level (10 mumol/l for the most concentrated solution), the zinc intake cannot induce any toxicity. For copper and selenium the results indicated a negligible pollution. Small-volume solutions added with zinc, copper and selenium are correctly supplemented. As regard aluminium pollution, 4 solutions among 12 contain non negligible amounts of aluminium. The consequences of this TPN overload especially for young infants, indicate that the struggle against this pollution has to be strengthened.