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Several basic studies have demonstrated that monocyte chemoattractant protein-1 (MCP-1) influences type 2 cytokine production and cell-mediated immunity. However, there have been few reports on the changes in serum MCP-1 levels in patients undergoing major thoracoabdominal surgery. In this study, we examined the kinetics of serum MCP-1 post-operatively and clarified its significance regarding the...
A 72-year-old man with non-Hodgkin’s lymphoma at the tracheal bifurcation node received combination chemotherapy and subsequently developed a fistula in spite of remission of the lymphoma. Conservative therapy did not heal the fistula formation, and we chose bypass surgery using a gastric tube without thoracotomy. Ten months postoperatively, there is no evidence of lymphoma relapse and the patient...
OBJECTIVES: We previously reported that ω-6 fat emulsion increases cytokine production in burned rats. Effects of soybean oil emulsion on surgical stress responses and lymphocyte function according to the surgical severity have not been studied in detail. We investigated the effects of soybean oil emulsion, which contains 50% ω-6 fatty acid, on postoperative stress responses and cell-mediated immune...
The operative procedure for thoracic esophageal cancer, including thoracotomy, laparotomy, and three-field lymph node dissection, is a particularly stressful surgery that is characterized by high morbidity and mortality. The aim of this study was to evaluate the immunologic and nutritional states of patients to determine possible predictive factors of morbidity and mortality in patients receiving...
Experimental studies have demonstrated that the route of nutritional supply impacts the systemic metabolic responses after surgical injury. Intestinal mucosal atrophy, as induced by total parenteral nutrition (TPN) or prolonged bowel rest, has been reported to enhance bowel endotoxin translocation. The operative procedure for thoracic esophageal cancer, including thoracotomy, laparotomy, and three-field...
Changes in immune function due to surgical injury have been well-documented. Immunosuppression is one of the causes of infectious complications leading to organ dysfunction in critical illness. It is not known what kind of surgery in the daily clinical practice causes immunosuppression. Stress response and immune function following surgery for esophageal carcinoma, assuming a highly-stressed operation,...
Postburn endotoxin translocation has been well documented. However, the relationship between the secretion of catabolic hormones, degree of endotoxin translocation, and intestinal atrophy has not been previously demonstrated. In this experiment, modulation of the secretion of catabolic hormones according to the route of nutrient administration was examined in burned animals. A total of 55 rats, with...
The effect of ω-3 fat emulsion on nitrogen retention and kinetics in relation to fatty acid profile were investigated in burned rats receiving total parenteral nutrition (TPN). A fat emulsion of a structured symmetrical triacylglycerol containing only eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (2:1) was prepared. Sprague-Dawley rats were fed by fat-free chow for 2 wk. Then rats were...
The effects of n-6 and n-3 polyunsaturated fatty acids (PUFA) on protein metabolism, cell-mediated immunity, and production of cytokines and prostanoids were studied in experimental animals and patients with esophageal cancer. In the experimental study using a rat burn model, n-6 PUFA increased serum interleukin-6 (IL-6) and tumor necrosis factor (TNF), α (P < 0.05), and decreased nitrogen balance...
A new fat emulsion of symmetrical triacylglycerols, containing only eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) was developed. The effects of this preparation on serum and liver fatty acid composition were investigated. Male Sprague-Dawley rats were fed a fat-free oral diet for 2 wk and were then divided into two groups. Seven rats were infused for 7 d with 1 mL of the new fat emulsion,...
The purpose of the study was to investigate the effect of insulin-like growth factor-1 (IGF-1) on the translocation of endotoxin from the gut of burned rats. Twenty-eight male Sprague-Dawley rats (7-wk-old) were subjected to 20% full-thickness scald burns and were divided into two groups. One group received 4 mg kg -1 d -1 of IGF-1 (IGF-1 group, n = 14), and the other...
The effects of recombinant human growth hormone (GH) and insulin-like growth factor-1 (IGF-1) were investigated in burned rats. Sprague-Dawley rats were fed exclusively by total parenteral nutrition and were subjected to 20% third-degree scald burns. The rats were then divided into the following three groups: (1) the GH group received GH at a dose of 1 IU kg -1 d -1 ...
The clinical significance of lipoprotein-X (Lp-X) induced by intravenous infusion of 10% fat emulsion was assessed, with special reference to atherogenesis, by in vitro experiment using purified Lp-X from the sera of patients receiving Intralipid 10%. Lp-X appeared after long-term intravenous infusion of 10% fat emulsion in the patients with intestinal fistula due to the anastomotic leakage. To...
Protein metabolism of skeletal muscle was studied in relation to severity of surgical stress and whole body protein metabolism in 24 patients undergoing a major surgical operation.The contribution of skeletal muscle protein breakdown to whole body protein breakdown increased significantly after surgical operation. There was a positive correlation between the contribution and urinary catecholamine...
The purpose of this study was to investigate the effects of human growth hormone (GH) on gene expression of albumin in the liver of burned rats.Eight male Sprague-Dawley rats (8 weeks old) were fed exclusively by TPN (200 kcal/kg/day, 6.2 g amino acid/kg/day) for 5 days. Then they were subjected to 20% full-thickness scald burns, and were divided into two groups. One group received 200 mU/day GH...
The purpose of this study was to investigate the effects of growth hormone (GH) on mRNA levels of structural proteins in skeletal muscle and diaphragm in burn injury.Eleven male Sprague-Dawley rats (7 weeks old) were fed exclusively by TPN for 5 days. Then they were subjected to 20% full-thickness scald burns, and were divided into two groups. One group received 200 mU/day of GH (GH group), and...
A study was conducted to clarify the quantitative relationship between the alteration of protein metabolism and the severity of surgical stress to further understand the mechanisms of body nitrogen losses in surgical trauma. Twenty-one patients undergoing esophagectomy for esophageal cancer (group E), and 22 undergoing gastrectomy or colorectal operations for gastric or colorectal cancer (Group GC)...
A study was conducted to clarify the contribution by myofibrillar protein to whole-body protein breakdown in surgically stressed patients. Thirteen patients who underwent esophagectomy (group E) and 22 who underwent gastric or colorectal operation (group GC) were studied. Patients were all male and younger than 65 y old. Whole-body protein breakdown was determined using constant infusion of ...
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