Liquid Diet Intake Research Articles

Application value of the π-shaped esophagojejunostomy in totally laparoscopic total gastrectomy

Objective To explore the safety and feasibility of the π-shaped esophagojejunostomy in totally laparoscopic total gastrectomy. Methods The retrospective cross-sectional study was conducted. The clinico-pathological data of 6 patients with gastric cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University between May 2016 and August 2016 were collected. All the 6 patients underwent totally laparoscopic total gastrectomy, operation procedures included esophagus and stomach mobilization, lymph node dissection, π-shaped esophagojejunostomy, and then laparoscopic digestive tract reconstruction after jejunojejunal anastomosis. Observation indicators included: (1) surgical situations: conversion to open surgery, operation time, time of π-shaped esophagojejunostomy, volume of intraoperative blood loss, number of lymph node dissected; (2) postoperative situations: time for initial out-of-bed activity, time of initial anal exsufflation, time of initial liquid-diet intake, time of abdominal drainage tube removal, postoperative complications and duration of postoperative hospital stay; (3) postoperative pathological examination; (4) follow-up and survival situations. Follow-up using outpatient examination was performed to detect the anastomotic stenosis, patients′ survival and tumor metastasis and recurrence up to November 2016. The measurement data with normal distribution were represented as ±s. Results (1) Surgical situations: all the 6 patients underwent successful totally laparoscopic total gastrectomy using the π-shaped esophagojejunostomy, without conversion to open surgery and perioperative death. Operation time, time of π-shaped esophagojejunostomy, volume of intraoperative blood loss and number of lymph node dissected were respectively (282±49)minutes, (37±9)minutes, (37±8)mL and 39±9. (2) Postoperative situations: time for initial out-of-bed activity, time of initial anal exsufflation, time of initial liquid-diet intake, time of abdominal drainage tube removal and duration of postoperative hospital stay of 6 patients were (44±38)hours, (72±21)hours, (6.5±1.1)days, (11±7)days and (15±7)days, respectively. Six patients were not complicated with postoperative hemorrhage, duodenal stump fistula and death. One patient with anastomotic fistula was cured by abdominal puncture drainage under guidance of computed tomography (CT), enteral nutrition and antibiotic therapy, and then was discharged from hospital. (3) Postoperative pathological examination: pTNM staging showed that stageⅠA, ⅡA, ⅡB and ⅢA were detected in 3, 1, 1 and 1 patients, respectively. (4) Follow-up and survival situations: 6 patients were followed up for 3-6 months, with a median time of 4 months. During follow-up, results of compound meglumine diatrizoate gastrointestinal radiography showed that there were smooth anastomoses, and no tumor recurrence or metastasis and death. Conclusion The π-shaped esophagojejunostomy is safe and feasible in totally laparoscopic total gastrectomy. Key words: Gastric neoplasms; Gastrectomy; π-shaped esophagojejunostomy; Laparoscopy

Clinical effect of vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer

Objective To explore the safety and feasibility of vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer. Methods The retrospective cross-sectional study was conducted. The clinicopathological data of 12 gastric cancer patients who underwent vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy at the Southwest Hospital of the Third Military Medical University from January 2015 to November 2016 were collected. All patients underwent vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer. During operation, lymph node dissection of the pyloric region, the right side of the cardia and the superior margin of the pancreas were noticed, and other surgical procedures were the same as the traditional Da Vinci robot-assisted radical gastrectomy. Observation indicators: (1) intra- and post-operative situations: surgical methods, digestive tract reconstruction, operation time, volume of intraoperative blood loss, number of lymph node dissected, results of postoperative pathological examination, recovery time of gastrointestinal function, time for liquid diet intake, duration of postoperative hospital stay, short-term surgery-related complications (postoperative bleeding, anastomotic fistula, obstruction and intra-abdominal infection); (2) follow-up situations: postoperative long-term complications (gastric retention, alkaline reflux gastritis, dumping syndrome, gallbladder disease and cholelithiasis), postoperative quality of life (diet, upper abdominal discomfort, nausea, vomiting and diarrhea), postoperative nutritional status [body weight, hemoglobin (Hb), total protein (TP), albumin (Alb)] and tumor recurrence. Follow-up using telephone interview and outpatient examination was performed up to December 2016. Telephone interview included detecting diet of patients, digestive tract symptoms and body weight. Routine blood test, liver and kidney functions, tumor markers, chest X-ray, abdominal computed tomography (CT) or color Doppler ultrasound and gastroscopy of outpatient examinations were performed to detect tumor recurrence and metastasis. Measurement data with normal distribution were represented as ±s and measurement data with skewed distribution were described as M (range). Results (1) Intra- and post-operative situations: all the 12 patients underwent successful vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer, without conversion to laparoscopic surgery or open surgery, including 2 patients with D1 lymphadenectomy, 2 patients with extended D1 lymphadenectomy and 8 patients with D2 lympha-denectomy. Five and 7 patients underwent respectively Billroth Ⅰ anastomosis and Billroth Ⅱ anastomosis of digestive tract reconstruction. Operation time, volume of intraoperative blood loss and number of lymph node dissected of 12 patients were (247±34)minutes, (94±23)mL and 27±7, respectively. Results of postoperative pathological examination showed that distal and proximal surgical margins of 12 patients were negative and achieved R0 resection; 326 lymph nodes were dissected, 6 patients didn′t have lymph node metastasis and 18 positive lymph nodes were detected in 6 patients. Recovery time of gastrointestinal function, time for liquid diet intake and duration of postoperative hospital stay in 12 patients were (57±14)hours, (64±14)hours and (7.3±0.9)days, respectively. There was no occurrence of short-term surgery-related complications. (2) Follow-up situations: 12 patients were followed up by telephone interview (10 receiving outpatient examinations) for 9 months (range, 1-20 months). Of 12 patients with long-term complications, 2 had loss of appetite, 1 had diarrhea, without occurrence of cholelithiasis, cholecystitis, gastric retention and dumping syndrome. Of 10 patients receiving outpatient examinations, body weight, Hb, TP and Alb were (56±12)kg, (126±10)g/L, (69.9±5.1)g/L, (43.2±3.3)g/L at 1 month postoperatively and (52±13)kg, (126±10)g/L, (72.1±2.4)g/L, (45.2±1.6)g/L at 3 months postoperatively, respectively, with negative carcinoembryonic antigen. There was no tumor recurrence and metastasis in 12 patients. Conclusion Vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy is safe and feasible for gastric cancer, which has not affected the lymph node dissection and incidence of surgery-related complications, and it also can improve the postoperative quality of life and maintain good nutritional status. Key words: Gastric neoplasms; Radical gastrectomy; Da Vinci robotic surgical system; Vagus nerve-preserving

Comparison of clinical effects between two models of alimentary reconstruction after total gastrectomy in the elderly patients with gastric cancer

Objective To investigate the comparison of clinical effects between two models of alimentary reconstruction after total gastrectomy in the elderly patients with gastric cancer. Methods 70 patients receiving alimentary tract reconstructions of Orr-type Roux-en-Y reconstruction (Orr-type, 40 cases) and modified Brawn Ⅰ (30 cases) from January 2007 to December 2012 were retrospectively analyzed.The operative time, amount of bleeding, early postoperative complications and mortality, food intake, nutritional status and alimentary tract function were compared at 6 months after surgery. Results There were no significant differences between the two methods in the operative time [(198.8±14.0)min vs 233.5±30.7)min, t=-1.697, P>0.05)], amount of bleeding [(420±43)ml vs (340±25)ml t=-1.956, P>0.05], and early postoperative complications [(17.5% vs 16.7% ), χ2 = 0.008, P>0.05]. However, times of liquid diet intake and semi liquid diet intake of the Orr-type reconstruction method was comparatively shorter than that of the modified Brawn Ⅰ[(4.8±2.1) d vs (7.6±2.4) d, and (9.5±3.6) d vs (11.5±3.7) d, t=-5.192, P 0.05). Conclusions Orr-type Roux-en-Y reconstruction method can avoid reflux esophagitis, and the procedure is more simple than the modified Brawn Ⅰmethod. Therefore, Orr-type Roux-en-Y reconstruction should be recommended as an adoptable method of digestive reconstruction after total gastrectomy for gastric cancer in the elderly patients. Key words: Gastric cancer; Total gastrectomy; Alimentary reconstruction

Retrospective analysis of multi-center data on the application of uncut Roux-en-Y gastrojejunostomy in totally laparoscopic distal gastrectomy

To investigate the feasibility and safety of uncut Roux-en-Y gastroduodenostomy in totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. Clinical data of 30 gastric cancer patients from 4 hospitals undergoing TLDG plus uncut Roux-en-Y gastroduodenostomy from February 2014 to January 2015 were analyzed retrospectively. Among 30 gastric cancer patients, 8 were in Guangdong General Hospital, 9 in The Second Hospital of Jilin University, 4 in Ruijin Hospital and 9 in Fujian Provincial Cancer Hospital, who were diagnosed as distal gastric cancer by pathology without distant metastasis. The clinical staging of these patients was stage I(A in 7 cases, stage I(B in 4, stage II(A in 6, stage II(B in 5, stage III(A in 5, stage III(B in 1, stage III(C in 2. All the main surgeons were experienced with more than 50 operations of totally laparoscopic distal gastrectomy for gastric cancer. All the 30 patients completed operations successfully. The incision length was (4.8±1.2) cm, total operation time and anastomosis time was (223.5±47.2) and (52.8±10.9) minutes, intra-operative blood loss was (53.0±30.7) ml and number of harvested lymph nodes was 36.9±0.9. No case was transferred to open operation. The detain time of gastric tube was (2.5±1.2) days, the first time to flatus was (2.9±0.9) days and the first time to liquid diet intake was (2.9±1.2) days. No perioperative death was found. Postoperative lymphatic leakage occurred in 1 case and peritoneal bleeding occurred in 1 case, which was cured by conservative treatment. No one developed anastomosis-related complication. Uncut Roux-en-Y gastroduodenostomy reconstruction is safe and feasible in totally laparoscopic distal gastrectomy for gastric cancer.

Hindbrain glucagon-like peptide-1 neurons track intake volume and contribute to injection stress-induced hypophagia in meal-entrained rats.

Published research supports a role for central glucagon-like peptide 1 (GLP-1) signaling in suppressing food intake in rodent species. However, it is unclear whether GLP-1 neurons track food intake and contribute to satiety, and/or whether GLP-1 signaling contributes to stress-induced hypophagia. To examine whether GLP-1 neurons track intake volume, rats were trained to consume liquid diet (LD) for 1 h daily until baseline intake stabilized. On test day, schedule-fed rats consumed unrestricted or limited volumes of LD or unrestricted volumes of diluted (calorically matched to LD) or undiluted Ensure. Rats were perfused after the test meal, and brains processed for immunolocalization of cFos and GLP-1. The large majority of GLP-1 neurons expressed cFos in rats that consumed satiating volumes, regardless of diet type, with GLP-1 activation proportional to intake volume. Since GLP-1 signaling may limit intake only when such large proportions of GLP-1 neurons are activated, a second experiment examined the effect of central GLP-1 receptor (R) antagonism on 2 h intake in schedule-fed rats. Compared with baseline, intracerebroventricular vehicle (saline) suppressed Ensure intake by ∼11%. Conversely, intracerebroventricular injection of vehicle containing GLP-1R antagonist increased intake by ∼14% compared with baseline, partly due to larger second meals. We conclude that GLP-1 neural activation effectively tracks liquid diet intake, that intracerebroventricular injection suppresses intake, and that central GLP-1 signaling contributes to this hypophagic effect. GLP-1 signaling also may contribute to satiety after large volumes have been consumed, but this potential role is difficult to separate from a role in the hypophagic response to intracerebroventricular injection.

The Outcomes of Management for Colonoscopic Perforation: A 12-Year Experience at a Single Institute.

PurposeOptimal management of colonoscopic perforation (CP) is controversial because early diagnosis and prompt management play critical roles in morbidity and mortality. Herein, we evaluate the outcomes and clinical characteristics of patients with CP according to treatment modality to help establish guidelines for managing CP.MethodsOur retrospective analysis included 40 CP patients from January 1, 2003, to December 31, 2014. Patients with CP were categorized into 2 groups according to therapeutic modality: operation (surgery) and nonoperation (endo-luminal clip application or conservative treatment) groups.ResultsThe postoperative morbidity rate was 40%, and no mortalities were noted. The incidence of abdominal pain and tenderness in patients who received only conservative management was significantly lower than in those who underwent surgery (P < 0.001 and P = 0.004, respectively). Patients tended to undergo surgery more often for diagnosis times longer than 24 hours and for diagnostic CPs. The mean hospital stays for the operation and nonoperation groups were 14.6 ± 7.77 and 5.9 ± 1.62 days, respectively (P < 0.001). Compared to the operation group, the nonoperation group began intake of liquid diets significantly earlier after perforation (3.8 ± 1.32 days vs. 5.6 ± 1.25 days, P < 0.001) and used antibiotics for a shorter duration (4.7 ± 1.29 days vs. 8.7 ± 2.23 days, P < 0.001).ConclusionThe time of diagnosis and the injury mechanism may be useful indications for conservative management. Nonoperative management, such as endo-luminal clip application, might be beneficial, when feasible, for the treatment of patients with CP.

Clinical efficacy of transanal endoscopic microsurgery for the rectal tumor

Objective To explore the clinical efficacy of transanal endoscopic microsurgery (TEM) for the rectal tumor. Methods The clinical data of 35 patients with rectal tumors who were admitted to the Second Affiliated Hospital of Nanchang University between November 2012 and March 2014 were retrospectively analyzed. The preoperative endorectal ultrasonography (ERUS) was applied to patients for evaluating local invasion and lymph node metastasis, and confirming the pathological types of tumors, size and location of tumors, depth of invasion and with or without lymph node enlargement around the rectal wall, and then patients underwent TEMs. Patients were followed up by outpatient examination, telephone interview and instant messenger (WeChat) till August 2014. Results The tumors of 6 patients were located in the anterior wall of rectum, 11 were in the posterior wall of rectum, 9 were in the left and 9 in the right side walls of rectum. The diameter of tumor, distances between distal margin of tumor and anal verge, volume of intraoperative blood loss and operation time were (2. 3 ± 0. 9) cm (range, 0.7–4. 8 cm) , (8 ± 4) cm(range, 4-17 cm) , (32 ± 19) mL (range, 5-60 mL) and (79 ± 35) minutes (range, 31-150 minutes) , respectively. Tumors with positive margin showed the negative margin after supplementary resection. All the patients didn't receive the specific analgesic therapy with the intake of liquid diets at postoperative day 1-3 , and they were discharged after anal exsufflation. The duration of hospital stay was (4. 2 ± 1. 2) days (range, 2.0-9. 0 days) . The results of pathological examination showed that rectal adenoma were detected in 12 patients, rectal carcinoma in situ in 2 patients (Tis stage) , rectal carcinoid in 2 patients, lowrisk T1 stage of rectal cancer in 9 patients, high-risk T1 stage in 7 patients and T2 stage in 3 patients who received chemotherapy. Seventeen patients had postoperative complications, including 9 with perineum swelling and frequent defecation, 4 with functional impairment of anal sphincter, 2 with acute urinary retention and 2 with mild errhysis with the eased symptoms after symptomatic treatment. A total of 35 patients were followed up for 5 – 22 months with a median time of 11 months. The recurrence rate of rectal cancer was 2/19, including in the lowand high-risk T1 stage of 1/16 and in T2 stage of 1/3. Two of 12 patients without adjuvant therapy had recurrence of tumors, and other patients had no recurrence of tumors after adjuvant therapy. Conclusion TEM is safe and feasible in the treatment of rectal adenoma, carcinoma in situ, rectal carcinoid as well as rectal cancer in the lowand high-risk T1 stage. Key words: Rectal neoplasms; Transanal endoscopic microsurgery; Efficacy

Functional relationship between oxytocin and appetite for carbohydrates versus saccharin.

Centrally acting oxytocin (OT) inhibits feeding. Recent evidence suggests a link between OT and control of carbohydrate and saccharin intake, but it is unclear whether OT affects appetite for only carbohydrates, especially sweet ones, or sweet tastants irrespective of their carbohydrate content. Therefore, a blood-brain barrier penetrant OT receptor antagonist, L-368,899, was administered in mice and intake of liquid diets containing carbohydrates sucrose, glucose, fructose, polycose, or cornstarch (CS) or the noncarbohydrate, noncaloric sweetener saccharin was studied in episodic intake paradigms: one in which only one tastant was available and the other in which a choice between a carbohydrate (sucrose, glucose, or fructose) and saccharin was provided. We also used real-time PCR to examine hypothalamic Ot mRNA levels in mice provided short-term access to sucrose, CS, or saccharin. In the no-choice paradigm, L-368,899 increased the intake of all carbohydrates, whereas its effect on saccharin consumption showed only a trend. A 10 times lower dose (0.3 mg/kg) stimulated intake of sucrose than other carbohydrates. In the choice test, a very low 0.1 mg/kg dose of L-368,899 doubled the proportion of sucrose consumption relative to saccharin, but did not affect fructose or glucose preference. Ot gene expression increased after sucrose and CS, but not saccharin exposure compared with the controls; however, a higher level of significance was detected in the sucrose group. We conclude that OT inhibits appetite for carbohydrates. Sucrose consumption considerably enhances Ot gene expression and is particularly sensitive to OT receptor blockade, suggesting a special functional relationship between OT and sugar intake.

Comparison of the clinical outcomes of laparoscopic-assisted versus open surgery for colorectal cancer.

The present study aimed to compare the clinical outcomes of laparoscopic-assisted surgery versus open surgery for colorectal cancer and investigate the oncological safety and potential advantages and disadvantages of laparoscopic-assisted surgery for colorectal cancer. The medical records from a total of 160 patients who underwent surgery for colorectal cancer between January 2009 and January 2013 at The Second Hospital of Dalian Medical University (Dalian, China) were retrospectively analyzed. The patients who underwent laparoscopic-assisted surgery showed significant advantages due to the minimally invasive nature of the surgery compared with those who underwent open surgery, namely, less blood loss (P=0.002), shorter time to flatus (P<0.001), bowel movement (P=0.009) and liquid diet intake (P=0.015), earlier ambulation time (P=0.006), smaller length of incision (P<0.001) and a shorter post-operative hospital stay (P=0.007). However, laparoscopic-assisted surgery for colorectal cancer resulted in a longer operative time (P=0.015) and higher surgery expenditure (P=0.003) and total hospitalization costs (P<0.001) compared with open surgery. There were no statistically significant differences between the intraoperative and post-operative complications. There were no differences in the local recurrence (P=0.699) or distant metastasis (P=0.699) rates. In addition, no differences were found in overall survival (P=0.894) and disease-free survival (P=0.701). These findings indicated that laparoscopic-assisted surgery for colorectal cancer had the clear advantages of a minimally invasive surgery and relative disadvantages, including a longer surgery time and higher cost, and exhibited similar rates of recurrence and survival compared with open surgery.

Effects of Crypthecodinium cohnii, Chlorela spp. and Isochrysis galbana addition to milk replacer on goat kids and lambs growth

The effects of Crypthecodinium cohnii (Cryp.), Chlorela spp. (Chlo.) and Isochrysis galbana (Iso.) addition to milk replacer on goat kids and lambs growth were evaluated. About 80 Majorera goat kids (males and females) and 80 Canarian sheep lambs were randomly assigned into four different groups (by specie) according to diet. Control groups were fed with a commercial milk replacer at 16% (w/w); Cryp. groups received a commercial milk replacer (15.1% w/w) supplemented with 9 g of a paste of C. cohnii; Chlo. groups received a commercial milk replacer (15.1% w/w) supplemented with 9 g of a paste of Chlorela spp.; Iso. groups received a commercial milk replacer (15.1% w/w) supplemented with 9 g of a paste of I. galbana. After colostrum period, animals were individually bottle-fed twice daily (8 am and 8 pm) ad libitum with the corresponding diet until day 60 of life. Animals were weighted every week at 8 am and liquid diet intake was recorded weekly. No effects of microseaweed addition were observed, neither growth nor milk replacer intake.

Repeated exposure to stress stimuli during ethanol consumption prolongs withdrawal-induced emotional abnormality in mice

The present study was designed to ascertain the influence of repeated exposure to stress on the development of ethanol dependence in mice. Mice were chronically treated with 3% ethanol for 7 days, with or without exposure to restraint stress for 1h/day. A significant loss of body weight was observed in the ethanol plus stress group compared with the other groups. In the ethanol plus stress group, mice exhibited persistent piloerection, which is considered to be a withdrawal sign that reflects emotion, after the discontinuation of ethanol treatment. The ethanol plus stress group also showed a marked increase in the intake of liquid diet, which is considered to be trying to avoid an unpleasant ethanol-withdrawal symptom, during ethanol withdrawal. In the hole-board test, a significant decrease in head-dipping behavior was observed in both the ethanol alone and ethanol plus stress groups at 6h after the discontinuation of ethanol treatment. This abnormal emotion was recovered in the ethanol alone group, but not in the ethanol plus stress group, at 48h after the discontinuation of ethanol treatment. These results suggest that repeated exposure to stress may affect the development of ethanol dependence and prolong the expression of withdrawal-induced emotional abnormality.

Application of modified loop ileostomy in laparoscopic low and super-low radical resection of the rectal cancer with preservation of anus

Objective To investigate the value of modified loop ileostomy in laparoscopic low and superlow radical resection of the rectal cancer with reservation of anus.Methods The clinical data of 108 patients who received laparoscopic low and super-low radical resection of rectal cancer with preservation of anus at the Subei Hospital of Jiangsu Province from January 2010 to June 2012 were retrospectively analyzed.Fifty-three patients who received preventive ileostomy were in the ileostomy group,and 55 patients who did not receive preventive ileostomy were in the non-ileostomy group.The operation,incidence of complication and follow-up of the 2 groups were analyzed.All data were analyzed using the t test,chi-square text or Fisher exact test.Results The operation time and blood loss were (185 ± 14)minutes and (31 ± 26)ml in the ileostomy group,and (154 ± 12)minutes and (28 ± 19)ml in the non-ileostomy group,with no significant difference between the 2 groups (t =2.34,1.82,P ＞ 0.05).The time to first flatus,time to liquid diet intake,time to pelvic drainage tube removal,duration of hospital stay,hospital costs were (1.1 ± 0.3) days,(1.1 ± 0.2) days,(5.2 ± 1.0) days,(7.2 ± 1.4) days,(3.0 ± 0.2) ×104 yuan in the ileostomy group,and (4.2 ± 0.6) days,(4.3 ± 0.6) days,(8.4 ± 3.9) days,(12.9 ±4.4)days,(3.8 ±0.7) × 104 yuan in the non-ileostomy group,with significant differences between the 2 groups (t =7.25,28.12,15.34,34.01,7.83,P ＜ 0.05).The incidences of postoperative complications and anastomotic fistula were 5.7％ (3/53) and 0 in the ileostomy group,and 21.8％ (12/55) and 12.7％ (7/55) in the non-ileostomy group,with significant differences between the 2 groups (P ＜ 0.05).Conclusion Modified loop ileostomy in laparoscopic low and super-low radical resection of rectal cancer can effectively reduce the incidence of anastomotic fistula,and helps the recovery of patients. Key words: Rectal neoplasms; Laparoscopy; Ileostomy

Inactivation of the median raphe nucleus increases intake of sucrose solutions: A microstructural analysis.

Previous studies have shown that microinjections of the GABA-A agonist muscimol into the median raphe nucleus (MR) result in large increases in the intake of solid foods. In the current study, we used microstructural techniques to characterize the effects of intra-MR muscimol injections on the consumption of either a 0.05 M or a 0.29 M sucrose solution. After injections of either saline or muscimol, animals consumed more of the 0.29 M than the 0.05 M solution, an effect which resulted primarily from increases in the initial rate of consumption with no change in the rate at which licking decayed across the test session. In contrast, intra-MR muscimol injections had little effect on the initial licking rate, but greatly increased meal duration, indicating that this treatment affected ingestion in a different way than did altering the sucrose concentration. Muscimol injections produced a significantly larger increase in the intake of the 0.29 M than of the 0.05 M solution. Intra-MR muscimol injections did not alter the within burst rate of licking, suggesting that they did not affect the functioning of the licking pattern generator. In contrast, these injections did increase the number of licks contained within "clusters," that is groups of licks separated from each other by intervals of more than 0.5 sec. These findings show that inactivation of the MR produces a powerful effect on the intake of liquid diets, and that the nature of this effect is different from that produced here by changes in sucrose concentration and from those reported after pharmacological manipulations of a number of other brain systems. We additionally discuss several theoretical issues arising in the interpretation of microstructural data. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Whey protein potentiates the intestinotrophic action of glucagon-like peptide-2 in parenterally fed rats

Glucagon-like peptide-2 (GLP-2) is a nutrient-regulated intestinotrophic hormone derived from proglucagon in the distal intestine. Enteral nutrients (EN) potentiate the action of GLP-2 to reverse parenteral nutrition (PN)-induced mucosal hypoplasia. The objective was to determine what enteral protein component, casein, soy, or whey protein, potentiates the intestinal growth response to GLP-2 in rats with PN-induced mucosal hypoplasia. Rats received PN and continuous intravenous infusion of GLP-2 (100 microg/kg/day) for 7 days. Six EN groups received PN+GLP-2 for days 1-3 and partial PN+GLP-2 plus EN for days 4-7. EN was provided by ad libitum intake of a semielemental liquid diet with different protein sources: casein, hydrolyzed soy, whey protein concentrate (WPC), and hydrolyzed WPC+casein. Controls received PN+GLP-2 alone. EN induced significantly greater jejunal sucrase activity and gain of body weight, and improved feed efficiency compared with PN+GLP-2 alone. EN induced greater ileal proglucagon expression, increased plasma concentration of bioactive GLP-2 by 35%, and reduced plasma dipeptidyl peptidase IV (DPP-IV) activity compared with PN+GLP-2 alone, P < 0.05. However, only whey protein, and not casein or soy, potentiated the ability of GLP-2 to reverse PN-induced mucosal hypoplasia and further increase ileal villus height, crypt depth, and mucosa cellularity compared with PN+GLP-2 alone, P < 0.05. The ability of whey protein to induce greater mucosal surface area was associated with decreased DPP-IV activity in ileum and colon compared with casein, soy, or PN+GLP-2 alone, P < 0.05. In conclusion, whey protein potentiates the action of GLP-2 to reverse PN-induced mucosal hypoplasia in association with decreased intestinal DPP-IV activity.

Effect of Consistency of Nutrient Intake from Milk and Milk Replacer on Dairy Calf Performance

<h2>ABSTRACT</h2> The effect of variable nutrient concentration in the liquid diet and variable intake of nutrients on ADG and feed efficiency of neonatal dairy calves was evaluated. Three treatments were fed in trial 1 that all provided 0.418kg DM/d. Treatment A was a 21% CP, 21% fat milk replacer (MR) powder. Treatment B was half DM supplied by the MR from treatment A and half DM from whole, saleable milk. Treatment C was all raw milk. In trial 2, two MR were fed at either a variable daily rate (0.525 to 0.788kg DM/d) or a fixed daily rate (0.653kg DM/d) to provide an average of 0.653kg DM/d in 4 treatments. The MR were either 27% CP and 31% fat (to simulate Holstein milk) or 27% CP and 17% fat. In trial 1, preweaning ADG, starter intake, feed efficiency, hip change, and BCS change were greater for calves fed treatment A vs. B and C. In trial 2, preweaning ADG and feed efficiency were less for calves fed the 31 vs. 17% fat MR. Calves fed the fixed rate of MR had greater ADG, starter intake, and efficiency than calves fed the variable rate of MR. Calves fed a consistent diet had greater ADG, starter intake, and feed efficiency than calves fed an inconsistent liquid (milk or MR) diet. Milk had more variation and greater concentrations of nutrients and bacteria than MR. A MR offers better potential to provide a consistent diet than milk.

口蓋扁桃摘出術術後の食事摂取量の比較

We compared caloric intake between liquid diet and Terumeal soft® (TERUMO) for two days after tonsillectomy. Terumeal soft is a paste type nutritious diet. Average caloric intake of iced Terumeal soft per day in one patient (704kcal) was significantly higher than the average caloric intake of liquid diet (493kcal). During this study, using a questionnaire survey, we compared the degree of pain and easiness of deglutition between patients eating liquid diet and patients eating Terumeal soft. We also compared the evaluations of taste and appearance between liquid diet and Terumeal soft. There was no significant difference in the degree of pain and easiness of deglutition between liquid diet and Terumeal soft. The evaluations of taste and appearance of Terumeal soft were significantly better than those of liquid diet. We concluded that the reason caloric intake of Terumeal soft was higher than that of liquid diet was that the taste and appearance were better, not that Terumeal soft decreased pain during eating or Terumeal soft was easier to deglute. The important thing that we should do to promote food intake by patients after tonsillectomy is to improve the taste and appearance of the food, rather than increasing the easiness of deglutition or decreasing the pain during eating. From this perspective, Terumeal soft is better than liquid diet for two days after tonsillectomy.

Intravenous Infusion of Peptide YY(3–36) Potently Inhibits Food Intake in Rats

Peptide YY (3-36) [PYY (3-36)] is postulated to act as a hormonal signal from the gut to the brain to inhibit food intake and gastric emptying. A mixed-nutrient meal produces a prolonged 2-3 h increase in plasma levels of both PYY (3-36) and PYY (1-36). We determined the dose-dependent effects of 3-h iv infusions of PYY (3-36) and PYY (1-36) (0.5-50 pmol.kg(-1).min(-1)) at dark onset on food intake in non-food-deprived rats. PYY (3-36) dose-dependently inhibited food intake: the minimal effective dose was 5 pmol.kg(-1).min(-1); the estimated potency (mean effective dose) and efficacy (maximal percent inhibition) were 15 pmol.kg(-1).min(-1) (2.6 nmol/kg) and 47%, respectively. PYY (1-36) was an order of magnitude less potent than PYY (3-36). Similar total doses of PYY (3-36) (0.9-30 nmol/kg) infused during the 15-min period just before dark onset also dose-dependently inhibited food intake, albeit with a lower potency and efficacy. Other experiments showed that PYY (3-36) inhibited food intake in sham-feeding rats and was more effective in reducing intake of a mixed-nutrient liquid diet than 15% aqueous sucrose. We conclude that: 1) iv infusions of PYY (3-36), which are more likely than ip injections to mimic postprandial increases in plasma PYY (3-36), potently inhibit food intake in a dose-dependent manner; 2) PYY (1-36) is an order of magnitude less potent than PYY (3-36); and 3) PYY (3-36) can inhibit food intake independently of its action to inhibit gastric emptying. It remains to be determined whether iv doses of PYY (3-36) that reproduce postprandial increases in plasma PYY (3-36) are sufficient to inhibit food intake.

Chronic Ethanol Feeding Potentiates α1‐Adrenoceptor Responsiveness in SHR Aortas

Previous studies including ours demonstrated a hypotensive response to ethanol in spontaneously hypertensive rats (SHRs). In this study, we investigated whether this hypotensive effect of ethanol involves alterations in vascular α1‐adrenergic receptor responsiveness. The contractile responses to the α1‐receptor agonist phenylephrine were evaluated in aortic rings obtained from pair‐fed SHRs receiving liquid diet with or without ethanol (2.5% or 5%, w/v) for 3 months. The responses were measured in aortas with and without endothelium to determine the role of the endothelium in the observed responses. The liquid diet intake was similar in the control and ethanol groups throughout the study whereas the body weight was significantly reduced by ethanol. Cumulative addition of phenylephrine (1 × 10−9–1 × 10−4 M) caused concentration‐related contractile responses. These responses were significantly reduced after endothelium denudation suggesting a role for the endothelium in the modulation of α1‐receptor responsiveness. Ethanol (2.5% and 5%) caused significant and concentration‐related increases in the contractile responses elicited by phenylephrine but not KCl. The maximum contraction (Emax) caused by phenylephrine in rings obtained from SHRs treated with 2.5% and 5% ethanol amounted to 413.6 ± 26.3 and 513.0 ± 46.7 mg tension/mg tissue, respectively, compared with 383.6 ± 35.2 mg tension/mg tissue in control rings. The enhancement of α1 contractions by ethanol was virtually abolished in rings pretreated with the α1‐receptor antagonist prazosin, suggesting upregulation of α1‐receptors in aortas of ethanol‐fed rats. Endothelium denudation also abolished ethanol‐evoked increases in phenylephrine contractions. These findings suggest that chronic ethanol feeding upregulates aortic α1‐receptors, which may be a consequence of chronic α1‐receptor blockade by ethanol. The latter may account, at least in part, for the hypotensive response elicited by ethanol in SHRs.

Fourth ventricular CART reduces food and water intake and produces a conditioned taste aversion in rats.

Cocaine- and amphetamine-regulated transcript peptide (CART) reduces rats' intake of liquid diet if the peptide reaches the 4th ventricle (4V). To test for specificity of 4V CART effects on feeding, the authors compared its ability to reduce intakes of liquid diet and water and tested for conditioned taste aversion (CTA). CART reduced 30-min intakes of both water and Ensure at a threshold of 1 microg. Lithium chloride (0.15 M, 20 ml/kg i.p.) and 4V CART (1 microg) paired with novel saccharin solution reduced saccharin preferences similarly in subsequent 2-bottle tests, compared with saline. Thus, CART can produce CTA. These data demonstrate that 4V CART's actions in ingestive behavior are not specific to nutrients and suggest that aspects of 4V CART's actions in reducing intake may be secondary to the production of an aversive state.

Neurotrophin-4 Deficient Mice Have a Loss of Vagal Intraganglionic Mechanoreceptors from the Small Intestine and a Disruption of Short-Term Satiety

Intraganglionic laminar endings (IGLEs) and intramuscular arrays (IMAs) are the two putative mechanoreceptors that the vagus nerve supplies to gastrointestinal smooth muscle. To examine whether neurotrophin-4 (NT-4)-deficient mice, which have only 45% of the normal number of nodose ganglion neurons, exhibit selective losses of these endings and potentially provide a model for assessing their functional roles, we inventoried IGLEs and IMAs in the gut wall. Vagal afferents were labeled by nodose ganglion injections of wheat germ agglutinin-horseradish peroxidase, and a standardized sampling protocol was used to map the terminals in the stomach, duodenum, and ileum. NT-4 mutants had a substantial organ-specific reduction of IGLEs; whereas the morphologies and densities of both IGLEs and IMAs in the stomach were similar to wild-type patterns, IGLEs were largely absent in the small intestine (90 and 81% losses in duodenum and ileum, respectively). Meal pattern analyses revealed that NT-4 mutants had increased meal durations with solid food and increased meal sizes with liquid food. However, daily total food intake and body weight remained normal because of compensatory changes in other meal parameters. These findings indicate that NT-4 knock-out mice have a selective vagal afferent loss and suggest that intestinal IGLEs (1) may participate in short-term satiety, probably by conveying feedback about intestinal distension or transit to the brain, (2) are not essential for long-term control of feeding and body weight, and (3) play different roles in regulation of solid and liquid diet intake.