Feasibility and potential benefit of maintenance endoscopic variceal ligation in patients with unresectable hepatocellular carcinoma and acute esophageal variceal hemorrhage: a controlled trial

BACKGROUND

Patients with unresectable hepatoma and acute esophageal variceal bleeding have extremely high rates of recurrent bleeding and mortality. This controlled study evaluates the feasibility and potential benefit of maintenance endoscopic variceal ligation in these patients.

METHODS

Patients with unresectable hepatoma and acute esophageal variceal bleeding underwent emergent endoscopic variceal ligation. After hemostasis, patients were randomized to undergo maintenance or esophageal variceal ligation (EVL) as necessary (demand ligation).

RESULTS

Fifty-four patients underwent maintenance EVL and 55 demanded EVL. One or more subsequent EVL session could be performed in only 30 patients (55.6%) in the maintenance group (actual maintenance ligation). Logistic regression analysis found that hepatic function determines the feasibility of maintenance ligation (Child-Pugh's A+B vs. C, OR 23.00: 95% CI [5.26, 100.66]). The survival and recurrent bleeding rates were similar in both groups. A subgroup analysis of patients with Child-Pugh's A and B hepatic reserve in both the maintenance EVL group (n = 24) and demand EVL group (n = 25) was performed to assess the potential benefit of maintenance ligation. Maintenance ligation reduced the rate of recurrent bleeding compared with demand ligation (p = 0.043). Cox regression showed that portal vein thrombosis and tumors in both hepatic lobes were also factors together with EVL that determined recurrence of bleeding. Survival was similar in both groups.

CONCLUSIONS

Maintenance ligation is feasible in patients with unresectable hepatoma and variceal hemorrhage if they have a good hepatic reserve. Maintenance ligation might lower the rate of recurrent bleeding in this subgroup of patients.

The emission characteristics of a small D.I. diesel engine using biodiesel blended fuels

Biodiesel and biodiesel blends provide low emissions without modification on the fuel system of conventional diesel engines. This study aims to develop a new domestic biodiesel production procedure which makes use of waste fryer vegetable oil by transesterification method, and further investigates the emission characteristics of a small D.I. diesel engine using biodiesel blends and diesel fuels, respectively. The 20/80 and 30/70 blends of biodiesel to diesel fuel are used in this study. The emission characteristics include smoke emissions, gaseous emissions (CO, HC, NOx and SO2), particle size distributions and number concentrations at a variety of steady state engine speed points. We have found that diesel engine fueled with biodiesel blends emits more PM2 particle number concentrations than those with diesel fuel, and PM2 number concentration increases as biodiesel concentration increases. As for the smoke and gaseous emissions, such as CO, HC, NOx and SO2, the results favored biodiesel blends.

Water-soluble organosulfur compounds of garlic inhibit fatty acid and triglyceride syntheses in cultured rat hepatocytes

The putative hypolipidemic effect of garlic remains controversial. To gain further insight into the effect of garlic on lipid metabolism, the present study determined the inhibitory effects of water-soluble organosulfur compounds present in garlic on triglyceride (TG) and fatty acid synthesis in cultured rat hepatocytes. When incubated at 0.05 to 4.0 mmol/L with cultured hepatocytes, S-allyl cysteine (SAC) and S-propyl cysteine (SPC) decreased [2-14C]acetate incorporation into triglyceride in a concentration-dependent fashion achieving a maximal inhibition at 4.0 mmol/L of 43 and 51%, respectively. The rate of [2-14C]acetate incorporation into phosphlipids was depressed to a similar extent by SAC and SPC. SPC, SAC, S-ethyl cysteine (SEC), and gamma-glutamyl-S-methyl cysteine decreased [2-14C]acetate incorporation into fatty acid synthesis by 81, 59, 35, and 40%, respectively, at 2.0-4.0 mmol/L concentrations. Alliin, gamma-glutamyl-S-allyl cysteine, gamma-glutamyl-S-propyl cysteine S-allyl-N-acetyl cysteine, S-allylsulfonyl alanine, and S-methyl cysteine had no effect on fatty acid synthesis. The activities of lipogenic enzymes, fatty acid synthase (FAS), and glucose-6-phosphate dehydrogenase (G6PDH) were measured in cultured hepatocytes treated with the inhibitors. The activity of FAS in cells treated with 4.0 mmol/L SAC and SPC, respectively, was 32 and 27% lower than that of nontreated cells. Neither SAC nor SPC affected G6PDH activity. The results indicate that SAC, SEC, and SPC inhibit lipid biosynthesis in cultured rat hepatocytes, and further suggest that these S-alk(en)yl cysteines of garlic impair triglyceride synthesis in part due to decreased de novo fatty acid synthesis resulting from inhibition on FAS. Whether tissue concentrations of active garlic components can achieve levels required to inhibit TG synthesis in vivo warrants further investigation.

Cholesterol-lowering effect of garlic extracts and organosulfur compounds: human and animal studies

The medicinal use of garlic dates back thousands of years, but there was little scientific support of its therapeutic and pharmacologic properties until recently. In the past decade, the cancer-protective effects of garlic have been well established by epidemiologic studies and animal experiments. However, the cardiovascular-protective properties of garlic are less well understood. In particular, despite the reported hypocholesterolemic effect of garlic, the mechanism of the effect is unclear. In a recent randomized, double-blind, placebo-controlled intervention study, we showed that aged garlic extract (AGE) supplementation was effective in lowering plasma concentration of total cholesterol by 7% and LDL cholesterol by 10% in hypercholesterolemic men compared with subjects consuming a placebo. Supplementation of AGE in animal diets similarly reduced plasma concentrations of total cholesterol and triacylglycerol by 15 and 30%, respectively. In subsequent experiments using cultured rat hepatocytes, we found 44--87% inhibition of cholesterol synthesis by the water-extractable fraction (WEF), methanol-extractable fraction (MEF) and petroleum ether-extractable fraction (PEF) of fresh garlic, and Kyolic (liquid form of AGE). These observations suggested that hydrophilic and hydrophobic compounds of garlic are inhibitory to cholesterol synthesis. Because S-allylcysteine (SAC) alone was less potent than Kyolic, which contains SAC and other sulfur compounds, a maximal inhibition appears to require a concerted action of multiple compounds of garlic. In a series of experiments, we further characterized the inhibitory potency of individual water-soluble and lipid-soluble compounds of garlic. Among water-soluble compounds, SAC, S-ethylcysteine (SEC), and S-propylcysteine (SPC) inhibited cholesterol synthesis by 40--60% compared with 20--35% by gamma-glutamyl-S-allylcysteine (GSAC), gamma-glutamyl-S-methylcysteine (GSMC) and gamma-glutamyl-S-propylcysteine (GSPC). Lipid-soluble sulfur compounds (i.e., diallyl sulfide, diallyl disulfide, diallyl trisulfide, dipropyl sulfide and dipropyl trisulfide) at low concentrations (0.05--0.5 mol/L) slightly (10--15%) inhibited cholesterol synthesis but became highly cytotoxic at high concentrations (1.0--4.0 mol/L). All water-soluble compounds, except S-allylmercaptocysteine, were not cytotoxic, judging from the release of cellular lactate dehydrogenase into the culture medium. Taken together, the results of our studies indicate that the cholesterol-lowering effects of garlic extract, such as AGE, stem in part from inhibition of hepatic cholesterol synthesis by water-soluble sulfur compounds, especially SAC.

The conception of depression in Chinese American college students

The conception of depression in Chinese American college students was examined with the Center for Epidemiologic Studies--Depression Scale (CES-D). It was hypothesized that, because of their significant engagement with mainstream American culture, these students' conception of depression would better approximate White Americans' differentiated view (L. Radloff, 1977) than the general Chinese American community's integrated view (Y. Ying, 1988). A total of 353 bicultural Chinese American college students participated in the study. Consistent with the hypothesis, principal-components factor analysis with varimax rotation revealed a factor structure and loading similar to that found in White American adults. Confirmatory factor analysis also showed Chinese American college students to better approximate Radloff's differentiated model based on her White American samples than Ying's integrated model based on her Chinese American community sample. Implications of the findings and directions for future research are discussed.

Inhibition of cholesterol biosynthesis by organosulfur compounds derived from garlic

The study was undertaken to test the inhibitory potential on cholesterogenesis of organosulfur compounds derived from garlic. The primary rat hepatocytes maintained in Dulbecco's modified Eagle's medium were treated with [2-14C]acetate as substrate for cholesterol synthesis in the presence or absence of test compounds at 0.05 to 4.0 mmol/L. Eleven water-soluble and six lipid-soluble compounds of garlic were tested. Among water-soluble compounds, S-allyl cysteine (SAC), S-ethyl cysteine (SEC), and S-propyl cysteine (SPC) inhibited [2-14C]acetate incorporation into cholesterol in a concentration-dependent manner, achieving 42 to 55% maximal inhibition. Gamma-glutamyl-S-allyl cysteine, gamma-glutamyl-S-methyl cysteine, and gamma-glutamyl-S-propyl cysteine were less potent, exerting only 16 to 29% maximal inhibitions. Alliin, S-allyl-N-acetyl cysteine, S-allylsulfonyl alanine, and S-methyl cysteine had no effect on cholesterol synthesis. Of the lipid-soluble compounds, diallyl disulfide (DADS), diallyl trisulfide (DATS), and dipropyl disulfide (DPDS) depressed cholesterol synthesis by 10 to 25% at low concentrations (< or =0.5 mmol/L), and abolished the synthesis at high concentrations (> or =1.0 mmol/L). Diallyl sulfide, dipropyl sulfide, and methyl allyl sulfide slightly inhibited [2-14C]acetate incorporation into cholesterol only at high concentrations. The complete depression of cholesterol synthesis by DADS, DATS, and DPDS was associated with cytotoxicity as indicated by marked increase in cellular LDH release. There was no apparent increase in LDH secretion by water-soluble compounds except S-allyl mercaptocysteine, which also abolished cholesterol synthesis. Judging from maximal inhibition and IC50 (concentration required for 50% of maximal inhibition), SAC, SEC, and SPC are equally potent in inhibiting cholesterol synthesis.

[The study of family structure, illness symptom, and stress adaptation of psychotic patients]

The major purposes of this paper are to explore the phenomena of family structure, illness symptoms, family coping and adaptation for patients with schizophrenia or manic-depression psychosis. This paper tries to provide a good reference instrument for application by nurses in home care, in order to understand and evaluate family needs. Subjects are schizophrenic or manic-depression outpatients from 3 hospitals located in northern Taiwan. Data were collected through home interview with primary caregivers and observations. There were fifty subjects from each of the 3 hospitals, and 151 subjects in total. Descriptive statistics, t-test, one way ANOVA, Pearson correlation and multiple stepwise correlation were used to analyze data. Research indicates that most patients are aged between 31 to 40, with over 10 years elapsed since onset, and are not married. Most primary caregivers are parents over 60 years old. Most family development was at the stage with young adult offspring. The manic-depressive patients have more working opportunities than schizophrenic patients. For schizophrenic patients, paranoia was the most serious in active symptoms; lack of interpersonal interaction was the most serious in negative symptoms; the other major problem was sleep disturbance in emotion-behavior assessment. Patient's disposition was the most concerning issue for families and the worst coping efficiency occurred with lazy behavior and sleep disturbance. For manic-depressive patients, aggressive behavior was the most serious active symptom, lack of energy was the most serious in negative symptom, and sleep disturbance was the most concerning problem in emotion-behavior assessment. The patient's symptom was the most concerning issue for families and the worst coping efficiency was found in drug side effect. The result also indicates that active and negative symptoms are both related to coping efficiency.

Dietary supplementation with arachidonic and docosahexaenoic acids has no effect on pulmonary surfactant in artificially reared infant rats

Despite the potential use of long chain polyunsaturated fatty acid (LCPUFA) supplementation to promote growth and neural development of the infant, little is known about potential harmful effects of the supplementation. The present study determined whether supplementation with arachidonic acid (AA) and/or docosahexaenoic acid (DHA) in rat milk formula (RMF) affects saturation of pulmonary surfactant phospholipids (PL). Beginning at 7 d of age, infant rats were artificially fed for 10 d with RMF supplemented with AA at 0, 0.5, and 1.0% of total fatty acid, or supplemented with DHA at 0, 0.5, and 1.0%, or cosupplemented with AA and DHA at levels of 0:0, 0.5:0.3, and 1.0:0.6% of the fat blend. Lung tissue PL contained 43 weight percent palmitate (16:0) of total fatty acids in infant rats fed the unsupplemented RMF. The supplementation with AA at both 0.5 and 1.0% decreased the weight percentage of 16:0 and stearate (18:0), indicating a decrease in saturation of PL. The observed decreases were accompanied by increases in AA and linoleic acid (18:2n-6). Surfactant phosphatidylcholine (PC) consisted of 71 weight percent 16:0 in the unsupplemented group, and this highly saturated PC was not altered by the cosupplementation with AA and DHA although there was a slight increase in DHA. Similarly, the cosupplementation did not change fatty acid composition of surfactant PL when compared with the unsupplemented group. The cosupplementation slightly decreased the weight percentage of 16:0 with a proportional increase in 18:0 leading to an unchanged weight percentage of total saturated fatty acids. These results suggest that, unlike lung tissue PL, the composition of saturated fatty acids in surfactant PL, particularly PC, is resistant to change by dietary AA and DHA supplementation. This, together with the unchanged concentration of total fatty acids in surfactant PC, indicates that LCPUFA cosupplementation causes no effect on pulmonary surfactant.

Case report: successful obliteration of a bleeding duodenal varix using endoscopic ligation

The occurrence of duodenal varices is rare and experience in the control of haemorrhage from duodenal varices is limited. A 69-year-old man with hepatocellular carcinoma presenting with upper gastrointestinal bleeding is reported. Emergency upper gastrointestinal endoscopy indicated one varix 1.5 cm in diameter with white nipple sign at the anterior wall of the duodenal bulb. Endosonography confirmed the diagnosis of duodenal varix. The patient was treated with endoscopic ligation and follow-up endoscopy showed complete eradication of duodenal varix 3 weeks later.

Modification of milk formula to enhance accretion of long-chain n-6 and n-3 polyunsaturated fatty acids in artificially reared infant rats

Artificially reared infant rats were used to determine the effects of long-chain polyunsaturated fatty acid (LCPUFA) supplementation on blood and tissue concentrations of arachidonic acid (AA) and docosahexaenoic acid (DHA). Beginning at 7 d of age, infant rats were fed for 10 d with rat milk formulas supplemented with AA at 0, 0.5 and 1.0%, or supplemented with DHA at 0, 0.5 and 1.0% of total fatty acid. The supplementation of AA increased accretion of the fatty acid in tissue and blood phospholipids with a maximum increase of 9% in brain, 15% in liver, 25% in erythrocytes, and 43% in plasma above the values of unsupplemented infant rats. Rat milk formula containing 1.0% of AA had no added benefits over that containing 0.5% of AA. The supplementation of DHA increased phospholipid DHA by a maximum of 24% in brain, 87% in liver, 54% in erythrocytes, and 360% in plasma above the unsupplemented control. The increase in tissue and blood DHA was concentration-dependent on formula fatty acid. Brain phosphatidylcholine and phosphatidylethanolamine were similarly enriched with AA and DHA by supplementation of the corresponding fatty acids. In general the observed increase of AA was accompanied by a decrease in 16:0, 18:1 n-9, and/or 18:2n-6, whereas the increased DHA was associated with a reduction of 18:1n-9, 18:2n-6, and/or 20:4n-6. Clearly, infant rats were more responsive to DHA than AA supplementation, suggesting a great potential of dietary manipulation to alter tissue DHA concentrations. However, the supplementation of DHA significantly decreased tissue and blood AA/DHA ratios (wt%/wt%), whereas there was little or no change in the ratio by AA supplementation. Although the physiological implications of the levels of AA and DHA, and AA/DHA ratios achieved under the present experimental conditions are not readily known, the findings suggest that artificial rearing could provide a suitable model to investigate LCPUFA requirements using various sources of AA and DHA in rats.

Desaturation of stearate is insufficient to increase the concentrations of oleate in cultured rat hepatocytes

Desaturation of stearate and palmitate and its effect on cellular accumulation of oleate were determined in primary culture of rat hepatocytes. The rate of oleate synthesis as measured by the formation of monounsaturated fatty acids from stearate was significantly higher than that from palmitate. The rate of [1-(14)C]stearate incorporation into oleate [1208 +/- 195 pmol/(mg protein x 4 h)] was 80% higher than that of [1-(14)C]palmitate [(672 +/- 82 pmol/(mg protein x 4 h)]. Despite the different rates of desaturation, the cellular oleate concentrations did not differ in the cells treated with stearate and palmitate (i.e., 42.5 +/- 4.5 vs. 40.8 +/- 5.2 nmol/mg protein). On the other hand, oleate concentration in the cells incubated with exogenous oleate was 198.1 +/- 9.5 nmol/mg protein. There was a dose-dependent increase in cellular stearate concentration by increasing stearate concentrations from 0.5 mmol/L to 4.0 mmol/L in culture medium. A linear increase in cellular stearate concentration was also achieved by increasing the duration of incubation with 1.0 mmol/L stearate from 2 to 24 h. Despite the marked increases in stearate concentrations under these conditions, oleate concentrations remained unchanged in the cells. These results do not support the contention that the hypocholesterolemic effect of stearate may be mediated by its conversion to oleate, although stearate is a more favorable substrate for desaturation than palmitate.

Stearic acid modifies very low density lipoprotein lipid composition and particle size differently from shorter-chain saturated fatty acids in cultured rat hepatocytes

Stearic acid as compared to myristate, palmitate, or oleate is poorly incorporated into triacylglycerol, a major lipid component of very low density lipoprotein (VLDL). The present study investigated the effects of these fatty acids on VLDL metabolism in cultured rat hepatocytes. All fatty acids stimulated [2-3H] glycerol incorporation into VLDL lipids and secretion of [3H]-labeled VLDL by hepatocytes. However, the rate of [3H]-labeled VLDL secretion in the presence of nonlabeled stearate (12.8 +/- 0.7 pmol/mg protein/4 h) was 46, 59, and 22% of that observed for those treated with myristate, palmitate, and oleate, respectively. [1-14C]Stearate as a substrate was also less effective than other labeled fatty acids to be incorporated into VLDL lipids. Of total VLDL lipids synthesized from [1-14C] stearate, triacylglycerol accounted for 78% as compared to 88-97% of that derived from palmitate, myristate, and oleate. The amounts of apoB100 and apoB48 were the same in hepatocytes treated with or without exogenous fatty acids. Similarly, the rate of apoB synthesis from [35S] methionine was not affected by exogenous fatty acids. The treatment of cells with various saturated fatty acids increased the particle size of VLDL to different extents. The largest particles of VLDL, with a mean diameter of 79.3 +/- 11.9 nm, were seen in the cells treated with stearate, followed by those treated with palmitate and myristate (45.5 +/- 9.8 and 38.6 +/- 6.8 nm, diameter, respectively). Clearly, hepatocytes treated with stearate secrete less VLDL and produce larger VLDL particles than those treated with shorter-chain saturated fatty acids.

Stearic acid unlike shorter-chain saturated fatty acids is poorly utilized for triacylglycerol synthesis and beta-oxidation in cultured rat hepatocytes

Utilization of stearate as compared to various saturated fatty acids for cholesterol and lipid synthesis and beta-oxidation was determined in primary culture of rat hepatocytes. At 0.5 mmol/L in the medium, stearate (18:0) adequately solubilized by albumin was less inhibitory to cholesterol synthesis from [2-14C] acetate than myristate (14:0) and palmitate (16:0) (68% vs. 91 and 88% inhibition, respectively). The rate of incorporation into cholesterol from [1-14C] stearate (3.0 +/- 0.6 nmol/mg protein/4 h) was 37-, 1.8-, and 7.8-fold of that from myristate, palmitate, and oleate, respectively. Conversely, the rate of [1-14C] stearate incorporation into total glycerolipids was 88-90% lower than that of labeled palmitate, myristate, and oleate. The rate of [1-14C] stearate incorporation into triacylglycerol (3.6 +/- 0.4 nmol/mg protein/4 h) was 6-8% of that from myristate, palmitate, oleate, and linoleate. The rate of stearate incorporation into phospholipids was the lowest among tested fatty acids, whereas the rate of mono- and diacylglycerol synthesis was the highest with stearate treatment. The rate of beta-oxidation as measured by CO2 and acid soluble metabolite production was also the lowest with [1-14C] stearate treatment at 22.7 nmol/mg protein/4 h, which was 35-40% of those from other [1-14C] labeled fatty acids. A greater proportion of stearate than other fatty acids taken up by the hepatocytes remained free and was not metabolized. Clearly, stearate as compared to shorter-chain saturated fatty acids was less efficiently oxidized and esterified to triacylglycerol in cultured rat hepatocytes.

Triacylglycerol and cholesterol transport during absorption of glycerol trioleate vs. glycerol trielaidate

We used conscious, chronic lymph-fistula rats to compare intestinal lymphatic transport of glycerol trioleate (TO) vs. glycerol trielaidate (TE) and to determine the effect of TO vs. TE on absorption and transport of cholesterol. Rats were implanted with intestinal lymph fistulas and duodenal cannulas and then given intraduodenal infusions of lipid emulsions containing purified TO or TE (40 mumol/h) and cholesterol (7.8 mumol/h + 2 microCi [14C]cholesterol). Lymph samples were collected at 0, 2, 4, 5, 6, 7, and 8 h after the start of lipid infusion. Lymphatic output and luminal and gut wall recovery of radioactive lipid at 8 h were quantified. Triacylglycerol (TG) fatty acid isomers did not affect lymphatic output of TG; lymph TG fatty acid composition and output reflected infusate composition. Lymphatic output of cholesterol (mass and radioactivity) did not differ between groups; luminal and gut wall recovery of [14C]cholesterol was also similar between groups. Similar lymphatic transport of TG and cholesterol between triolein- and trielaidin-infused rats was maintained for up to 16 h after the cessation of an infused lipid load. These results indicate that TO and TE are transported into lymph similarly, and that cholesterol absorption and transport are similar irrespective of whether TO or TE is the TG source. The data suggest that trans fatty acid-induced hypercholesterolemia is not due to altered intestinal absorption and transport of cholesterol.

Segregation by color and stereoscopic depth in three-dimensional visual space

Two experiments were conducted to investigate how color and stereoscopic depth information are used to segregate objects for visual search in three-dimensional (3-D) visual space. Eight observers were asked to indicate the alphanumeric category (letter or digit) of the target which had its unique color and unique depth plane. In Experiment 1, distractors sharing a common depth plane or a common color appeared in spatial contiguity in the xy plane. The results suggest that visual search for the target involves examination of kernels formed by homogeneous items sharing the same color and depth. In Experiment 2, the xy contiguity of distractors sharing a common color or a common depth plane was varied. The results showed that when target-distractor distinction becomes more difficult on one dimension, the other dimension becomes more important in performing visual search, as indicated by a larger effect on search time. This suggests that observers can make optimal use of the information available. Finally, color had a larger effect on search time than did stereoscopic depth. Overall, the results support models of visual processing which maintain that perceptual segregation and selective attention are determined by similarity among objects in 3-D visual space on both spatial and nonspatial stimulus dimensions.

Lymphatic absorption of enterally fed structured triacylglycerol vs physical mix in a canine model

The lymphatic absorption of a structured triacylglycerol vs an equivalent physical mixture of the constituent medium-chain triacylglycerol and fish oils was studied. Each of four canines served as its own control in a crossover feeding design with the investigators unaware of diet contents. Lymphatic absorption of n-3 and medium-chain fatty acids peaked within 4-8 h of feeding either diet. The lymph contained more 10:0 fatty acids than 8:0 despite an overall ratio of 10:0 to 8:0 of 0.3 for the diets. The mass of medium-chain fatty acids absorbed in the lymph at measured time points was 2.6 +/- 0.5-fold higher (mean +/- SE of 12 determinations) for the structured triacylglycerol compared with the physical mix. Molecular species analyses revealed that the medium-chain fatty acids in lymph were present as mixed triacylglycerols. The unique molecular structure of these mixed triacylglycerols and the fatty acids at the 2-position may account for the improved absorption.

Linolenic acid provides a source of docosahexaenoic acid for artificially reared rat pups

The goal of the present study was to determine the effectiveness of linolenic acid for enriching docosahexaenoic acid (DHA) in infant rats. Seven-day-old rat pups were artificially reared and fed intragastrically for 8 d a milk substitute containing either 1) corn oil, high in linoleic acid (35.6 g/100 g fatty acids, 775 kJ/L); 2) menhaden oil, high in DHA (3 g/100 g, 67 kJ/L) and eicosapentaenoic acid (EPA, 6 g/100 g, 132 kJ/L); or 3) linseed oil, rich in linolenic acid (34 g/100 g, 750 kJ/L). Growth rates were comparable among the artificially fed pups and those raised by lactating dams. Feeding the DHA precursor linolenic acid enriched EPA in plasma, erythrocytes and liver, but enriched DHA only in the liver, compared with feeding corn oil. The proportion of liver DHA in the pups fed the linolenic acid-rich substitute was twice that detected in the corn oil-fed pups and 60% of the level found in the pups fed the preformed DHA. The significant elevation of hepatic DHA indicates active desaturation and elongation in the developing rat liver. The failure to enrich erythrocyte DHA suggests the need for caution in the use of erythrocytes as an index of DHA status in tissues capable of in situ synthesis. The artificial rearing of rat pups was proven suitable for studying the interaction of dietary manipulation and tissue accretion of essential fatty acids during the postnatal development.

Arachidonic acid and eicosapentaenoic acid stimulate type II pneumocyte surfactant secretion

Arachidonic acid and its leukotriene metabolites have been shown to stimulate surfactant secretion by alveolar type II cells. The present study was undertaken to determine the effects of various unsaturated fatty acids, including eicosapentaenoic acid, on surfactant secretion. Surfactant secretion was expressed as the percent of [3H]choline-derived phospholipids released into culture medium by type II pneumocytes of adult rats. Consistent with the earlier findings, arachidonic acid stimulated secretion in a concentration-dependent fashion (3.5-21 microM), doubling baseline secretion at 21 microM. Eicosapentaenoic acid was found to be equally effective as arachidonic acid in stimulating secretion. A comparison with palmitic, oleic and linoleic acids revealed that highly unsaturated fatty acids stimulated secretion to the greatest extent. This was supported by a positive correlation between degree of unsaturation (i.e., 0, 1, 2, 4 and 5 double bonds) and stimulation of surfactant secretion. In the present study, exogenous leukotriene E4 (10(-13)-10(-6) did not stimulate surfactant secretion. Neither nordihydroguairetic acid (0.1 microM) nor indomethacin (0.1 microM) affected arachidonic acid-stimulated secretion. The stimulatory effects of arachidonic acid and eicosapentaenoic acid on surfactant secretion were related to the highly unsaturated nature of the fatty acids and were not mediated by increased levels of cyclic adenosine monophosphate or calcium.

Selectivity of cyclopean masking for the spatial frequency of binocular disparity modulation

Previous studies have presented evidence for the existence of channels tuned to the spatial frequency (SF) of binocular disparity modulation. Bandwidths reported for masking curves were extremely narrow, possibly because of off-frequency viewing, whereby observers can best detect a signal with a channel tuned to an SF on the opposite side of the signal from the masker's SF, rather than with a channel tuned directly to the signal's SF. Herein are reported the results of four detection experiments. Experiment 1 measures unmasked threshold for detection of a cyclopean grating. Experiments 2-4 are masking experiments. Experiment 2 demonstrates that threshold for detection of a cyclopean grating is proportional to the intensity of masking noise, which is consistent with the operation of linear channels. Experiments 3 and 4 demonstrate that masking curves are narrower when obtained with narrowband-noise maskers than when obtained with notched-noise maskers, which render the off-frequency viewing ineffective. Implications for understanding the processing of cyclopean images are discussed.

Garlic reduces plasma lipids by inhibiting hepatic cholesterol and triacylglycerol synthesis

Prompted by the reported hypolipidemic activity of garlic, the present study was undertaken to elucidate the mechanism(s) underlying the cholesterol-lowering effects of garlic. Rat hepatocytes in primary culture were used to determine the short-term effects of garlic preparations on [1-14C]acetate and [2-3H]glycerol incorporation into cholesterol, fatty acids and glycerol lipids. When compared with the control group, cells treated with a high concentration of garlic extracts [i.e., petroleum ether- (PEF), methanol- (MEF) and water-extractable (WEF) fractions from fresh garlic] showed decreased rates of [1-14C]acetate incorporation into cholesterol (by 37-64%) and into fatty acids (by 28-64%). Kyolic containing S-allyl cysteine and organosulfur compounds inhibited cholesterogenesis in a concentration dependent manner with a maximum inhibition of 87% at 0.4 mM. At this concentration, Kyolic decreased [1-14C]acetate incorporation into fatty acids by 67%. S-allyl cysteine at 2.0 and 4.0 mM inhibited cholesterogenesis by 20-25%. PEF, MEF and WEF depressed the rates of [2-3H]glycerol incorporation into triacylglycerol, diacylglycerol and phospholipids in the presence of acetate, but not in the presence of oleate. The results suggest that the hypocholesterolemic effect of garlic stems, in part, from decreased hepatic cholesterogenesis, whereas the triacylglycerol-lowering effect appears to be due to inhibition of fatty acid synthesis. Primary hepatocyte cultures as used in the present study have been proven useful as tools for screening the anticholesterogenic properties of garlic principles.

Maternal dietary fish oil enriches docosahexaenoate levels in brain subcellular fractions of offspring

Prompted by the speculated essentiality of docosahexaenoic acid (DHA) for neural development, this study was undertaken to investigate the incorporation of (n-3) fatty acids in the maternal diet into various phospholipids of infant rat brain subcellular fractions: microsomes (Ms), synaptosomes (Sy), myelin (My), and mitochondria (Mt). Two groups of infant rats were nourished by dams fed diets containing 20% of either corn oil (CO) or menhaden oil (MO) from 2 until 12 days of age. DHA but not eicosapentaenoic acid (EPA) was distributed to all subcellular fractions of infant rats in the CO group. The levels of DHA were higher in Ms and Mt than Sy and My, and higher in phosphatidylethanolamine (PE) and phosphatidylserine (PS) than phosphatidylcholine (PC) and phosphatidylinositol (PI). The MO feeding enriched DHA in PE of all subcellular fractions, PS of all subcellular fractions, except My, PC of Sy, My and Mt, and PI of My. EPA was enriched in phospholipids in all subcellular fractions, except mitochondrial PS of the MO group. In the MO group, the ratios of EPA/DHA, ranging from 0.01 to 0.85, in all subcellular phospholipids were markedly lower than that found in the mother's milk (i.e., 1.5), suggesting an ability to elongate and desaturate EPA to DHA and/or disproportional uptake of the fatty acids by the brain. In PE of all subcellular fractions, the increased levels of DHA and EPA, with a concomitant reduction of arachidonic and/or linoleic acid, yielded higher ratios of total (n-3)/(n-6) fatty acids in the MO than the CO group. The inclusion of preformed DHA and EPA in the maternal diet provides an effective means to enrich these fatty acids in developing brains.

The effects of dietary fish oil on alveolar type II cell fatty acids and lung surfactant phospholipids

The purpose of this study was to determine the responsiveness of alveolar type II cells to dietary fish oil and the consequent effects on alveolar and lung surfactant. Rats were fed a corn oil or a fish oil diet for four weeks. Dietary n-3 fatty acids were readily incorporated into the type II cell phospholipids as indicated by higher levels of eicosapentaenoic acid (2.77 +/- 0.10%) and docosahexaenoic acid (1.63 +/- 0.10%) in the group receiving the fish oil diet. The elevated levels of n-3 fatty acids were accompanied by concomitant reduction in arachidonic acid and linoleic acid. Neither eicosapentaenoic acid nor docosahexaenoic acid was incorporated into type II cell triacylglycerols. Feeding a fish oil containing diet increased surfactant phospholipids, particularly 1,2-disaturated acyl phosphatidylcholines in whole lung compared to a corn oil diet. However, the amount of surfactant found in the alveolus was not different between the two diet treatment groups. The results suggest that dietary n-3 fatty acids stimulate synthesis and/or inhibit degradation of lung surfactant without altering surfactant secretion in alveoli.

Changes in plasma and erythrocyte fatty acids in patients fed enteral formulas containing different fats

Critically ill hospital patients were fed enteral formulas containing different fat substrates. Seven patients received formula X, which contained 28 g of structured triglycerides and menhaden oil to provide 7.6 g of medium-chain fatty acids, 2.5 g linoleic acid, 1.3 g eicosapentaenoic acid, and 0.4 g docosahexaenoic acid per 1000 mL of formula. Six patients received formula Y consisting of 36.8 g of medium-chain triglycerides and corn and soy oils providing 14.3 g medium-chain fatty acids and 11.7 g linoleic acid per 1000 mL. Feeding of formula X increased plasma total phospholipid levels of eicosapentaenoic acid on days 7 and 14 and docosahexaenoic acid levels on day 14. Plasma levels of linoleic acid were reduced in formula-X-fed in comparison to formula-Y-fed patients, whereas arachidonic acid was maintained in both groups during feeding. As a result of these changes, the patients receiving formula X had decreased ratios of arachidonic acid:eicosapentaenoic acid in plasma. Formula Y feeding did not alter eicosapentaenoic acid and docosahexaenoic acid levels in the plasma. In the erythrocyte, formula X feeding resulted in a threefold increase in eicosapentaenoic acid from mean baseline levels of 0.4 +/- 0.4% to a mean value of 1.2 +/- 0.9% at day 7. The formula X feeding decreased linoleic acid levels on days 7 and 14, whereas levels of arachidonic acid and docosahexaenoic acid remained constant. Formula Y feeding did not affect any of the parameters measured for erythrocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetonitrile as a substitute for ethanol/propylene oxide in tissue processing for transmission electron microscopy: comparison of fine structure and lipid solubility in mouse liver, kidney, and intestine

Tissue processing for transmission electron microscopy (TEM) is commonly accomplished using ethanol (EtOH) as a dehydrating solvent and propylene oxide (PO) as a transition fluid. Both solvents have some undesirable properties: EtOH solubilizes lipids; PO is highly flammable, volatile, toxic, and potentially carcinogenic. Their replacement by a compound devoid of these characteristics is therefore desirable. Acetonitrile (AN) appears to be such a solvent. It is freely miscible with water, alcohols, acetone, and epoxy resins; it does not interfere with epoxy polymerization; and the resulting cured resins have excellent cutting quality and beam stability. AN is also an excellent dehydrating agent whose use does not necessitate modification of current techniques. Most importantly, the low solubility of phospholipids (PL) in AN limits the loss of membrane lipids and, hence, leads to a better preservation of tissue features.

Movement and focused attention: a failure to replicate

Our original goal was to explore the nature of the grouping-by-movement phenomenon reported by Driver and Baylis (1989). In their studies, distractors that moved in common with a centrally located target had a larger influence on focused-attention performance than did more proximate but stationary distractors. These results seemed particularly important since they suggested, contrary to the predictions of space-based models of attention, that attention could be allocated to noncontiguous regions of the visual field. Their results also suggested mandatory processing of stimuli with common motion. Unfortunately, we were unable to replicate this grouping-by-movement effect. In the conditions of Experiment 1 in which we replicated Driver and Baylis's methodology, stationary distractors produced a larger response-compatibility effect than did the more distant distractors that moved in common with the target. In Experiment 2, we redundantly coded the centrally located target and the far distractors with common movement and color. However, the results were identical to those obtained in Experiment 1. The stationary near distractors that appeared in a different color from the target and the far distractors produced the largest response-compatibility effect. In a final experiment, we attempted to compensate for the reduced acuity of the moving distractors by adjusting their size by a cortical magnification factor. However, even with this manipulation, we found a larger response-compatibility effect for the stationary near distractors than for the moving distant distractors. Our results suggest that subjects are capable of selectively processing a target item that moves in common with distractors.

Substrate utilization for phosphatidylcholine synthesis by type II pneumocytes of neonatal rats

Type II pneumocytes isolated from neonatal rat lungs, using an isolation procedure developed for adult rats, were found to be phenotypically stable and metabolically active in culture. The cells, purified by metrizamide gradient centrifugation and differential adherence, were capable of synthesizing phospholipids from 14C-labeled choline, palmitate, glucose, and acetoacetate. Regardless of the 14C-labeled substrates used, greater than two thirds of the radioactivity incorporated into phosphatidylcholine was recovered in disaturated phosphatidylcholine, the major component of surfactant phospholipids. The incorporation of palmitate into phosphatidylcholine and other phospholipids (i.e. phosphatidyl-ethanolamine, -glycerol, -serine, and -inositol) indicates that the neonatal type II cells have the capacity to produce surfactant lipids. The neonatal cells preferentially utilized acetoacetate over glucose as a precursor of phospholipids. In the adult type II cells, glucose was incorporated into phospholipids more rapidly than acetoacetate. The rate of glucose incorporation in the neonatal cells was enhanced by exogenous insulin. The preferential utilization of acetoacetate by the neonatal type II cells is consistent with the stimulated acetoacetyl CoA synthetase pathway in the lung. The depressed glucose incorporation into phospholipid, on the other hand, may be attributed to insulin insufficiency in the neonate.

Enrichment of (n-3) fatty acids of suckling rats by maternal dietary menhaden oil

The study was undertaken to determine whether the content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in neonatal rats can be increased through milk provided by lactating mothers fed a diet containing 20% menhaden oil (experimental group), in comparison with a group fed a 20% corn oil diet (control group). The test diets were isocaloric and provided 41% of total energy as fat. Coinciding with 3-9% higher maternal body weight gain throughout the lactation period with the menhaden oil diet, the suckling rats in the experimental group at the ages of 3-9 d gained 5-10% more weight than did their control counterparts. When compared with corn oil, maternal dietary menhaden oil induced not only a higher weight percentage but also higher concentrations (microgram/mL) of EPA, DHA and total (n-3) fatty acids in milk, plasma, platelets and erythrocytes of neonates. These changes were accompanied by lower arachidonic and linoleic acid levels. EPA and DHA were detected in all three blood components of the control group, whose corn oil diet contained linolenic acid but not longer chain (n-3) fatty acids. This finding, together with the higher DHA to EPA ratios found in the three blood components than in the milk of the experimental group, suggests that neonatal rats possess the enzymes necessary for producing DHA from EPA and linolenate by desaturation and elongation mechanisms.

Long chain fatty acid deficits in brain myelin sphingolipids of undernourished rat pups

A restricted maternal dietary intake (40% of ad libitum intake) is known to cause myelin deficit that is accompanied by decreased amounts of individual phospholipids and sphingolipids in brain myelin of suckling rats. This communication reports the effects of the same nutritional stress on the fatty acid composition of brain myelin lipids. In myelin of 19-day-old normally fed rats, palmitate (16:0), stearate (18:0) and oleate (18:1) accounted for 80-90% of all fatty acids in phosphatidylcholine, phosphatidylethanolamine and phosphatidylserine. Maternal dietary restriction resulted in deficits of total fatty acid content, but did not affect the proportional distribution of individual fatty acids among phospholipids. By contrast, longer chain (22- and 24-carbon) fatty acids accounted for more than half the fatty acid content of myelin cerebroside and sulfatide from the 19-day-old control rat pups. In undernourished rats of that age, proportions of lignocerate (24:0) and nervonate (24:1) in cerebroside and sulfatide were 40-50% lower than those in control rats. This, together with higher proportions of 16:0, 18:0 and 18:1 and a higher ratio of C16-C20 to C22-C24 in undernourished than in control rats, suggests an impairment in fatty acid chain elongation. Ten days of nutritional rehabilitation failed to restore the fatty acid imbalances; however, after an additional 5 days of ad libitum feeding, the experimental and control values were similar. The undernutrition results in hypomyelination, which is characterized by a proportional decrease in lignoceric and nervonic acids of sphingolipids.

Maternal dietary restriction causes myelin and lipid deficits in the brain of offspring

The relationship between brain myelination and nutritional insufficiency in suckling rats whose dams had a restricted dietary intake was studied. The undernourished pups were characterized by body weight and brain weight that were 40-70% and 82-88% that of controls throughout the suckling period. Myelin concentrations, whether expressed as mg protein or as mg myelin dry weight per g wet brain, were 30-40% of normally fed controls. Myelin of undernourished rats contained total lipid, cholesterol, phospholipids, and sphingolipids that were 42, 54, 39, and 48%, respectively of the control counterparts. There was no change in the mole ratio of cholesterol:phospholipids:sphingolipids (i.e., cerebroside + sulfatide) in myelin from undernourished rats. Concentrations of individual phospholipids and sphingolipids were lowered by approximately the same percentage. Despite long-lasting, irreversible stunting of whole-body and brain growth, concentrations of myelin and myelin lipids returned to control levels after nutritional rehabilitation. Since the observed effects are different from those of more commonly used models, the present form of undernutrition may offer a useful system for studying the relationship between myelin lipids and brain development.

Soybean oil emulsion administration during parenteral nutrition in the preterm infant: effect on essential fatty acid, lipid, and glucose metabolism

To examine the effect of a soybean oil emulsion on essential fatty acid, lipid, and glucose metabolism, preterm infants were randomized to receive 0.5 g/kg/d lipid for 5 days (n = 10, group 1) or 0.5 increased to 2.0 g/kg/d over 5 days (n = 11, group 2). Triene/tetraene ratios did not change in group 1, but decreased in group 2. In both groups, plasma phospholipid linoleate (percent and micrograms per milliliter) increased, the increase being greater in group 2. In both groups, percent content of arachidonate and 5,8,11-eicosatrienoate decreased, and that of oleate remained unchanged. In contrast, absolute content of arachidonate and oleate tended to increase, and that of 5,8,11-eicosatrienoate remained unchanged. At a lipid intake of 0.5 g/kg/d, no infants had hyperlipemia. When lipid intake exceeded 1.0 g/kg/d, the frequency of hypertriglyceridemia (triglycerides greater than 200 mg/dL) and free fatty acidemia, with the free fatty acid/molar albumin ratio exceeding 6:1, increased. Plasma glycerol increased slightly, but was substantially less than the rise in enzymatically determined triglycerides. Hyperglycemia was self-limiting and did not require alteration in dextrose intake. Thus, (1) infusion of a soybean oil emulsion at 0.5 to 2.0 g/kg/d maintains essential fatty acid status and phospholipid arachidonate concentrations; (2) significant hyperlipemia occurs when lipid intake exceeds 1.0 g/kg/d; (3) hyperglycemia associated with lipid infusion tends to be self-limiting and may not require alteration in lipid or dextrose intake; and (4) enzymatically determined triglycerides may be used to monitor lipid tolerance, provided that allowance is made for a small but systematic overestimation resulting from the rise in plasma glycerol.

Surfactant phospholipids and lavage phospholipase A2 in experimental Pneumocystis carinii pneumonia

The effect of Pneumocystis carinii pneumonia on surfactant phospholipids and lavage phospholipase A2 was investigated. Pneumocystis carinii infection was induced in adult rats by immunosuppression with dexamethasone administered in the drinking water (2 mg/L) for 6 to 8 wk. Surfactant phospholipids were isolated from lung lavage and lung tissue. Dexamethasone administration significantly increased total lung and lavage phospholipids in corticosteroid-treated animals receiving prophylaxis against P. carinii with trimethoprim-sulfamethoxazole (TMP-SMZ) when compared with no treatment control animals. Lavage surfactant phospholipids from P. carinii-infected rats were 25% that of no treatment control rats and less than 10% that of corticosteroid control animals receiving TMP-SMZ. Phospholipid composition of lavage phospholipids was also altered in P. carinii pneumonia, with slight increase in the percentage of sphingomyelin and reduced percentage of total phosphatidylcholine. Postlavage tissue phospholipids of P. carinii-infected rats were 4 times that of no treatment control animals, although only about 50% that of corticosteroid control animals. There was no significant difference in lavage phospholipase A2 activity for the P. carinii-infected and corticosteroid control groups, although the enzyme activity was at least 4 times that of the no treatment control group. The surfactant changes were associated with abnormal excised lung pressure-volume curves and decreased deflation stability in the animals with P. carinii. These results indicate that the corticosteroids used in this model induce an increase in both lung surfactant phospholipids and phospholipase A2. Despite this increase in lavage phospholipids, P. carinii pneumonia in this model causes an alveolar surfactant phospholipid deficiency without significant increase in phospholipase A2 activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Pulmonary surfactant lipid synthesis from ketone bodies, lactate and glucose in newborn rats

The contribution of acetoacetate (AcAc), beta-hydroxybutyrate (beta OHB), lactate and glucose to pulmonary surfactant lipid synthesis in three- to five-day-old rats was measured. Minced lung tissue was incubated with 3H2O and [3-14C]AcAc, [3-14C]beta OHB, [U-14C]lactate or [U-14C]glucose, and the radioactivity incorporated into surfactant lipids was measured. When expressed as nmol of substrate incorporated/g lung tissue per four hr, lactate was incorporated more rapidly than other substrates into total surfactant lipids and phosphatidylcholine (PC). There was no difference in the rates of incorporation of lactate, AcAc or glucose into disaturated PC (DSPC). Substrates other than glucose were incorporated almost exclusively into fatty acids, whereas 60-80% of glucose incorporated into surfactant phospholipids was found in fatty acids, with the remaining in glyceride-glycerol. When expressed as nmol acetyl units incorporated/g lung tissue per four hr, the rates of AcAc, lactate and glucose incorporation into total surfactant fatty acids were comparable. Glucose incorporation into DSPC and PC was greater than that of AcAc and lactate. When glucose was the only exogenous substrate added to the incubation medium, it contributed 37% of total surfactant fatty acids synthesized de novo. In the presence of other substrates, the contribution of glucose to de novo fatty acid synthesis dropped to 14-20%. In the presence of unlabeled glucose, 14C-labeled AcAc, lactate and beta OHB contributed 52%, 40% and 19%, respectively, of the total fatty acids synthesized de novo. The rate of beta OHB incorporation into surfactant lipids was only about 50% that of other substrates and was accompanied by low activity of beta-hydroxybutyrate dehydrogenase measured for newborn lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Allocation of attention in the visual field

This research investigated whether attentional resources can be simultaneously allocated to several locations in a visual display, whether the mode of processing (serial or parallel) can be switched within a trial, and the nature of the costs when attentional resources are concentrated on an invalid location. Subjects were required to determine which of two target letters was present in eight-letter circular displays. In precue conditions, a primary and a secondary target location were designated 150 ms before target onset by an indicator that varied in validity. In the control conditions no cue was provided. A second experiment verified several assumptions that had been made in interpreting the data of Experiment 1. Modifications in Jonides' (1983) two-process model were suggested in terms of a zoom lens model of attentional resources. Instead of two alternative processing modes, attentional resources are conceived as capable of distribution over the visual field, but with low resolving power, or as continuously constricting to small portions of the visual field with a concomitant increase in processing power.

Impairment of lipid emulsion metabolism associated with carnitine insufficiency in premature infants

Carnitine status and its relation to lipid metabolism were determined in 11 premature infants (less than 34 weeks of gestation) receiving parenteral nutrition. Intravenous administration of lipid emulsion increased serum concentrations of free fatty acids at 2, 4, and 8 h after infusion. Despite this increase, serum levels of ketone bodies remained low, reaching only 40 to 45% of levels in full-term infants receiving enteral feeds. In premature infants, levels of plasma total and free carnitine were about half those in full-term infants and were not altered by lipid infusion. The results indicate limited potential for lipid emulsion as a source of energy in premature infants, possibly because carnitine insufficiency restricts fatty acid oxidation.

Safflower oil emulsion administration during parenteral nutrition in the preterm infant. 1. Effect on essential fatty acid status

To determine the effect of a safflower oil emulsion on the essential fatty acid (EFA) status of preterm infants during parenteral nutrition, subjects were randomized to receive Liposyn at 0.34 g (group 1), 0.68 g (less than 0.5% of lipid from linolenic acid, group 2), or Modified Liposyn at 0.68 g/kg/day (5.0% of lipid from linolenic acid, group 3). Doses of 0.34 and 0.68 g of Liposyn provided linoleic acid in amounts equivalent to 2 and 4% of the estimated caloric requirement (120 cal/kg/day) and 5 and 10% of the actual caloric intake. No significant differences were detected in plasma phospholipid triene/tetraene ratios and arachidonic acid levels between groups 1 and 2 or between groups 2 and 3, respectively. Plasma phospholipid triene/tetraene ratio and arachidonic acid did not change in the lipid-supplemented group throughout the study period, but the former remained significantly lower (p less than 0.001) and the latter significantly greater (p less than 0.001) than in a reference group of infants who received fat-free parenteral nutrition. We conclude that Liposyn administration providing linoleic acid at 2 or 4% of the estimated caloric requirement or 5 or 10% of the actual caloric intake prevented any significant changes in essential fatty acid status from occurring. Moreover, linolenic acid supplementation at 5% of the total lipid intake did not appear to affect arachidonic acid synthesis in the preterm infant.

Safflower oil emulsion administration during parenteral nutrition in the preterm infant. 2. Effect on triglyceride and free fatty acid levels

During a study to evaluate the effect of a safflower oil emulsion on essential fatty acid status during parenteral nutrition, we also measured plasma triglycerides and plasma free fatty acids (FFA) in a group of preterm infants. Subjects received 0.34 g/kg (group 1) or 0.68 g/kg (group 2) of lipid daily for 5 days. Essential fatty acid status remained normal in both groups, but the changes in plasma triglycerides were greater (p less than 0.025), and hypertriglyceridemia was somewhat more common (p = 0.06) in group 2 than in group 1. Plasma FFA did not differ in either treatment group. However, postinfusion FFA were greater (p less than 0.05) and FFA uptake was less (p less than 0.05) in infants at less than 32 than at 32-34 weeks gestation, but in no instance did postinfusion FFA exceed an FFA/albumin ratio of 6:1. In addition, triglyceride and FFA uptake did not improve during the study, but the changes in plasma triglycerides and FFA were greater (p less than 0.05) at the end than at the beginning of the study.

Preferential utilization of ketone bodies in the brain and lung of newborn rats

Persistent mild hyperketonemia is a common finding in neonatal rats and human newborns, but the physiological significance of elevated plasma ketone concentrations remains poorly understood. Recent advances in ketone metabolism clearly indicate that these compounds serve as an indispensable source of energy for extrahepatic tissues, especially the brain and lung of developing rats. Another important function of ketone bodies is to provide acetoacetyl-CoA and acetyl-CoA for synthesis of cholesterol, fatty acids, and complex lipids. During the early postnatal period, acetoacetate (AcAc) and beta-hydroxybutyrate are preferred over glucose as substrates for synthesis of phospholipids and sphingolipids in accord with requirements for brain growth and myelination. Thus, during the first 2 wk of postnatal development, when the accumulation of cholesterol and phospholipids accelerates, the proportion of ketone bodies incorporated into these lipids increases. On the other hand, an increased proportion of ketone bodies is utilized for cerebroside synthesis during the period of active myelination. In the lung, AcAc serves better than glucose as a precursor for the synthesis of lung phospholipids. The synthesized lipids, particularly dipalmityl phosphatidylcholine, are incorporated into surfactant, and thus have a potential role in supplying adequate surfactant lipids to maintain lung function during the early days of life. Our studies further demonstrate that ketone bodies and glucose could play complementary roles in the synthesis of lung lipids by providing fatty acid and glycerol moieties of phospholipids, respectively. The preferential selection of AcAc for lipid synthesis in brain, as well as lung, stems in part from the active cytoplasmic pathway for generation of acetyl-CoA and acetoacetyl-CoA from the ketone via the actions of cytoplasmic acetoacetyl-CoA synthetase and thiolase.

Allocation of attention in the visual field

This research investigated whether attentional resources can be simultaneously allocated to several locations in a visual display, whether the mode of processing (serial or parallel) can be switched within a trial, and the nature of the costs when attentional resources are concentrated on an invalid location. Subjects were required to determine which of two target letters was present in eight-letter circular displays. In precue conditions, a primary and a secondary target location were designated 150 ms before target onset by an indicator that varied in validity. In the control conditions no cue was provided. A second experiment verified several assumptions that had been made in interpreting the data of Experiment 1. Modifications in Jonides' (1983) two-process model were suggested in terms of a zoom lens model of attentional resources. Instead of two alternative processing modes, attentional resources are conceived as capable of distribution over the visual field, but with low resolving power, or as continuously constricting to small portions of the visual field with a concomitant increase in processing power.

Ketone body synthesis from leucine by adipose tissue from different sites in the rat

Leucine is catabolized to ketone bodies in adipose tissue, but the contribution of this output to overall ketone metabolism is not known. The intent of the present study was to determine the capacity of different adipose tissues to synthesize ketone bodies from leucine. The amino acid was readily converted into acetoacetate in epididymal, perirenal, and omental fat tissues. In rats fed ad libitum, the rate of acetoacetate synthesis in omental fat (about 2 mumol g tissue-1h-1) was at least 8 times higher than in epididymal or perirenal fat. In omental fat, the rates of acetoacetate formation from alpha-ketoisocaproic acid were 47-55% lower than from leucine at all concentrations examined. There was no significant synthesis of beta-hydroxybutyrate from leucine or alpha-ketoisocaproic acid. After oxidative decarboxylation, a greater proportion (about three-fourths) of leucine in omental fat was metabolized to acetoacetate than to CO2 production through the Krebs cycle. Although addition of glucose, pyruvate, or carnitine did not affect the production of acetoacetate, fasting for 24 h stimulated acetoacetate synthesis from leucine and alpha-ketoisocaproic acid in omental fat. The high rate of leucine conversion to acetoacetate in omental fat was related to high activities of leucine aminotransferase and branched-chain alpha-keto acid dehydrogenase. Moreover, protein content and cytochrome c oxidase activity of omental mitochondria were, respectively, 13 and 12 times higher than in epididymal mitochondria. In contrast, fat content of epididymal adipose tissue was 21 times that of omental adipose tissue. Epididymal depot consisted of 2.0% protein and 75.8% fat, whereas omental depot contains 17.2% protein and 3.6% fat, resembling that of liver and muscle. The results suggest that the high ketogenic capacity of omental fat stems in part from an augmented mitochondrial mass and high activity of branched-chain alpha-keto acid dehydrogenase.

Essential fatty acid status of the premature infant during short-term fat-free parenteral nutrition

This study was designed to evaluate the effect of fat-free parenteral nutrition on the essential fatty acid status of a group of stable premature infants during the first 10 days of life. Nine infants had a gestational age of less than 32 weeks (Group 1), and 10 infants, 32-34 weeks (Group 2). Five of nine infants in Group 1 and two of 10 infants in Group 2 developed essential fatty acid deficiency (EFAD) (triene/tetraene ratio greater than 0.4). In three infants, EFAD was present by 5 days of age; and in four, between 5 and 10 days of age. The difference in frequency of EFAD between Groups 1 and 2 is statistically significant (p less than 0.05). The development of EFAD as a function of postnatal age could be predicted using a simple regression, y = -0.14 + 0.07x (r = 0.64, p less than 0.0001), where y represents the triene/tetraene ratio and x the postnatal age in days. We conclude that (a) EFAD may develop rapidly in the premature infant; (b) the more immature the infant, the greater the risk of EFAD; (c) the degree of EFAD increases with the duration of fat-free parenteral nutrition.

Temporal changes in plasma levels and metabolism of ketone bodies by liver and brain after ethanol and/or starvation in C57BL/6J mice

The effects of ethanol and starvation on ketone body production and utilization were investigated. In the first experiment, adult C57BL/6J mice were divided into four groups: (i) control (fed); (ii) starvation (up to 31 h); (iii) ethanol (acute 5 g/kg i.p.); (iv) ethanol (ETOH) + starvation. Plasma ketone body (KB) concentrations in control mice remained constant at approx. 0.37 mM. The levels of KBs in starved mice began to increase at about 7 h and rose to a peak of 2.5 mM at about 24 h, then fell to 1.8 mM at 31 h. The levels in mice treated with ETOH began to rise soon after injection, reached 1.5 mM at 10 h, and returned to control levels by 15 h. Although there was no difference in elevated levels of KBs between two groups of mice treated with ETOH plus starvation and ETOH alone at 7-10 h, the level continued to rise steadily to 2.0 mM through 31 h in the former group. At 10 h post ETOH, mice either fed ad lib. or fasted had increased hepatic capacity to synthesize acetoacetate (AcAc) from palmitate; this effect was prolonged and enhanced by continued fasting for 24 h. In the brain, the rate of AcAc oxidation was twice that for beta-hydroxybutyrate (beta OHB) and glucose. Neither ETOH nor starvation affected energy production from KB and glucose. AcAc was also utilized for fatty acid synthesis and the rate of synthesis was stimulated by ETOH at 10 h after injection. The rate of lipogenesis from beta OHB accounted for less than 10% of that from AcAc. Together these experiments demonstrate that ETOH increases both hepatic ketone production and plasma KB levels for at least 10 h. ETOH alone led to elevated KB levels long before the rise due to starvation. In brain, at 10 h, an increased capacity to utilize AcAc for lipogenesis was found. The results indicate that ETOH through the production of KBs could provide an important source of energy and lipid precursors for the brain of mice.

Pathways of acetyl CoA production for lipogenesis from acetoacetate, beta-hydroxybutyrate, pyruvate and glucose in neonatal rat lung

The rate of fatty acid synthesis from acetoacetate (AcAc) is 2-3 times greater than from glucose in developing rat lung. To determine the reason for this difference, we investigated the pathways of lipogenesis from [3-14C] AcAc, [3-14C] beta-hydroxybutyrate (beta OHB), [U-14C] glucose or [2-14C] pyruvate in minced lung tissue of 3- to 4-day-old rats. The addition of (-)hydroxycitrate, an inhibitor of ATP-citrate lyase, inhibited fatty acid synthesis from glucose, pyruvate, and beta OHB by 88%, 70% and 60%, respectively, but had no effect on that from AcAc. Benzene 1,2,3-tricarboxylate, an inhibitor of tricarboxylate translocase, inhibited fatty acid synthesis from all substrates by at least 50%. Incubation with aminooxyacetate, an inhibitor of aspartate aminotransferase, had no effect on lipid synthesis from glucose, pyruvate or AcAc, but increased lipid synthesis from beta OHB. Results indicate that for lipid synthesis in the neonatal lung, acetyl CoA from AcAc is derived predominantly from a cytoplasmic pathway involving AcAcCoA synthetase and AcAcCoA thiolase, whereas citrate is the major route of acetyl group transfer from glucose. Lipogenesis from beta OHB involves both the cytoplasmic and citrate pathways.

Biosynthesis of phospholipids and sphingolipids from acetoacetate and glucose in different regions of developing brain in vivo

The incorporation of 14C-label from subcutaneously injected [3-14C]acetoacetate and [U-14C]glucose into phospholipids and sphingolipids in different regions of developing rat brain was determined. In all regions, phosphatidylcholine was the lipid synthesized most readily from either substrate. The percentages of radioactivity in other phospholipids and most sphingolipids remained relatively constant throughout postnatal development. An exceptional increase in the percentage of radioactivity incorporated into cerebroside, coinciding with a decrease of incorporation into phosphatidylcholine, was first noted on day 12 and continued until a maximal level was reached between days 18 and 20 of postnatal age. These developmental changes in preferential synthesis of lipids were associated with increased demands for phospholipids and cerebroside during the early and late postnatal stages, respectively. There was no difference in accumulation of radioactivity from acetoacetate, expressed as dpm of [14C]acetoacetate recovered in phospholipids plus sphingolipids per g of tissue, among all brain regions during the first 5 days of life. During active myelination (12 to 20 days of age); however, the amount of 14C-label was highest in brain stem, ranging from 1.9- to 2.3-fold greater than values for cerebrum and thalamus. The region with the next highest accumulation was cerebellum, followed by midbrain. During the same period, brain stem was likewise the most active site of accumulation of radioactivity from 14C-labeled glucose. Higher amounts of [14C]acetoacetate label accumulated in lipids of brain stem and cerebellum, relative to midbrain, thalamus, and cerebrum, coincide with evidence that active myelination begins in the hindbrain and proceeds rostrally toward the forebrain. Ketone bodies could therefore serve as a potential source of phospholipids and sphingolipids for brain growth and maturation.

Lung lipid synthesis from acetoacetate and glucose in developing rats in vitro

Acetoacetate (AcAc) and glucose were compared as energy sources and as precursors for lipid synthesis in the lungs of developing rats. Minced lung tissue was incubated with [3-14C]AcAc or [U-14C]glucose and the oxidation of each substrate to CO2 or its incorporation into tissue lipids was quantified. The highest rates of oxidation were obtained during the first 5 days for AcAc and the first 2 days of life for glucose and oxidation of AcAc was 3-4 times greater than that of glucose at all ages. Throughout postnatal development, the rates of nonsaponifiable lipid, fatty acid and hence total lipid (chloroform/methanol extractable) synthesis from AcAc were 2-3 times those of glucose. The highest rates of total lipid synthesis from AcAc and glucose were observed at birth. Glucose was utilized for glyceride-glycerol synthesis at a higher rate than AcAc. Similar patterns of incorporation of AcAc and glucose into various lipid classes were noted. Of the total lipids synthesized from AcAc and glucose, respectively, phospholipid plus monoglyceride accounted for 64% and 77%, triglyceride 13% and 13%, diglyceride plus cholesterol 11% and 4%, fatty acids 9% and 4%, and cholesteryl esters 3% and 1%. AT birth, the specific activities of all lipids except triglyceride derived from AcAc were greater than those from glucose. Rates of synthesis of all complex lipids declined with age. The results of these experiments demonstrate that AcAc is utilized more readily than glucose for energy production and lipid synthesis in developing rat lungs.

Changes in lipogenic capacity and activities of ketolytic and lipogenic enzymes in brain regions of developing rats

Oxidation of ketone bodies (KBs) generates acetyl coenzyme A (AcCoA), which can be further incorporated into fatty acid. We have determined the rates of lipogenesis from ketone bodies in developing rats and their relation to the activities of enzymes involved in the production of cytoplasmic AcCoA via different pathways in brain regions. In the cerebrum (Cbr), rates of fatty acid synthesis from [3-14C]acetoacetate ([3-14C]AcAc) were high during the early postnatal period but decreased rapidly thereafter until weaning. Although similar developmental patterns of synthesis characterized the cerebellum (Cbl), midbrain (Mb), brain stem (Bs), and thalamus (Th), maximal rates were highest in the Cbr and lowest in the Th. In all regions, synthetic rates were higher throughout the entire suckling period than in adulthood. There were not appreciable differences in synthetic rates among brain regions of adult rats. The developmental changes in rates AcAc incorporation into fatty acids were closely related to AcAcCoA synthetase activity, but not to activities of ATP-citrate lyase or AcCoA synthetase. During the early postnatal stage enhanced rates of lipogenesis were accompanied by increased activities of AcAcCoA synthetase in all regions, with the highest activity occurring in the Cbr. The sequence of reactions coupling AcAcCoA synthetase and AcAcCoA thiolase in cytoplasm may be an important pathway for generation of AcCoA from KBs for fatty acid synthesis in all regions of the developing brain. This interpretation is strengthened by evidence of concomitant increases in the activities of fatty acid synthetase and AcCoA carboxylase.

Effect of postnatal undernutrition on ketone metabolism and its relation to metabolic changes in brain and liver of rats

The effects of undernutrition on ketone metabolism and its relation to brain growth in developing rats were studied. In the first series of experiments, undernutrition was induced by increasing the litterr size from 4 to 16 pups. Body weight of pups was inversely related to litter size. Increasing the litter size lowered brain weight by 6-16% and liver weight by 20-46%. The ratio of brain weight:body weight was greater by 16 to 39% in the larger litters. Increasing the litter size did not alter concentration of brain lipid. liver glycogen or plasma ketone bodies. In the second series of experiments, undernutrition was induced by restricting maternal dietary intake to 40% of that of the control dam. This undernutrition caused a more pronounced growth retardation than that resulting from increasing litte size. At 14 days of age, the mean body weight of the undernourished group was 44% lower than the control value. The dietary restriction lowered brain weight by 19%, liver weight by 38%, liver glycogen by 47%, brain lipid by 11%, plasma ketone bodies by 30%, glucose by 37% and the rate of hepatic ketogenesis by 28%. The results suggest that brain-growth retardation is related to low brain lipids and impaired ketone metabolism.