Co-variation between walking ability and circulatory alterations in patients with intermittent claudication.

Unselected patients (n = 183) with subjective symptoms of intermittent claudication were examined clinically and by various circulatory tests (calf blood-flow, ankle, toe pressures). The aims of the present study were to evaluate to what extent the central or peripheral circulation is limiting in unselected patients with subjective symptoms of intermittent claudication, to determine the co-variation between the maximum walking capacity and traditional haemodynamical measures mentioned above and to evaluate to what extent a traditional bicycle ergometer exercise test and treadmill walking test give similar information regarding maximum performance. Eighty-five per cent of all patients were or had been smokers and 16% were diabetics. The mean ankle/brachial blood pressure index was 0.58 +/- 0.02 and the average post-ischemic maximum calf bloodflow was 13.3 +/- 0.6 ml/min/100 ml tissue. Leg arterial insufficiency was the limiting factor of walking capacity in 90% of all patients at 87 +/- 2 W corresponding to a walking distance of 282 +/- 13 m, while leg exhaustion was the limiting factor in 80% of the patients during test on the bicycle ergometer at maximum 84 +/- 2W. The mean maximum walking capacity for all patients was 86 +/- 3W and the mean maximum capacity on the bicycle ergometer was 87 +/- 2W. The ankle/brachial index showed only a weak correlation (r = 0.30, p < 0.002) to walking capacity. Our results demonstrate that the maximum walking capacity on a treadmill agrees with mean values of maximum exercise capacity on a bicycle ergometer.(ABSTRACT TRUNCATED AT 250 WORDS)

The incidence of spontaneous mammary carcinoma in C3H mice is influenced by dietary fat given from weaning and given to the mothers during gestation and lactation.

The influence of dietary fat given to breeding C3H female mice during gestation and lactation on the incidence of spontaneous mammary carcinoma in the female offspring was studied. EWOS' commercial diet (E-diet) for mice and two test diets, one containing 2% soy oil (S-diet) and the other 2% soy oil and 0.1% methoxy-substituted glycerol ethers (MGE-diet), instead of the animal fat in the E-diet, were used. The breeding females were given the S- or MGE-diet during gestation and lactation and the progeny the S- or E-diet from weaning. The incidence of mammary carcinoma was studied in the force-bred progeny. The results disclosed significant correlations between the diets of the progeny and the number of litters and between the number of litters and the incidence of breast carcinoma. The results also indicated a strong influence of the mother's diet on the incidence of mammary carcinoma in the female progeny.

The fat composition of a mouse diet modifies the effects of levamisol on growth and spread of a murine tumor.

The fat composition of the diet fed to C57BL/6J mice influenced the effect of Levamisol on the growth and spread of LLT. The timing of feeding of different diets as well as of the administration of Levamisol in relation to tumor transplantation was of importance. The tumor-suppressive effect of Levamisol given on day 9 was counteracted by a diet containing 2% soy oil instead of animal fat and given from day 1. Levamisol given on day 1 counteracted the facilitation of tumor growth and spread by the soy oil diet given from day 9. The soy oil diet was shown to suppress the immune response to SRBC. We conclude that standardization of the laboratory diets is necessary.

Comparison of an elemental and two polymeric diets in colectomized patients with or without intestinal resection.

The absorption of nutrients and minerals from the small bowel on enteral diets of different composition has been studied in seven ileostomy patients without or with only minor (< 100 cm) distal small bowel resection (group A) and in nine patients with major (> 100 cm) resections, i.e. jejunostomies (group B). In group A, a moderate-fat polymeric diet (MF) was compared to a peptide-based low-fat elemental diet (PD). Nitrogen and potassium absorption was higher on the MF, while the absorption of other nutrients and minerals studied did not differ. In group B a low-fat polymeric diet (LF) was also tested. Jejunostomy volumes were higher on the PD diet compared to the polymeric diets, as were losses of sodium and potassium. Nitrogen absorption was lower on the PD diet. Comparison of the MF and LF polymeric diets showed equal energy losses, while jejunostomy volumes and sodium losses were higher on the MF diet. Calcium absorption was higher and balance better on the LF diet. We conclude, that (a) elemental diets offer no nutritional advantages in enteral feeding of patients with intact or impaired small bowel function, and (b) we suggest that a low-fat polymeric diet could replace elemental diets in patients with malabsorption.

The effect of citrus pectin on the absorption of nutrients in the small intestine.

The extent of hydrolysis of citrus pectin in the stomach and small intestine was studied by in vivo digestion in ileostomy patients. The effect of citrus pectin on ileostomy losses of fat, nitrogen, starch, sodium and potassium was also investigated as was its effect on the absorption of phosphorus, calcium, magnesium, zinc and iron. Six ileostomy patients were studied during 10 d while on a constant low-fibre diet supplemented with 15 g citrus pectin/d on days 5, 6 and 7. The constituents mentioned in (1) as well as neutral polysaccharides, uronic acids and Klason lignin were determined in the ileostomy contents and duplicate portions of the diet. Of the uronic acids derived from the citrus pectin 70-100 per cent was recovered in the ileostomy contents. The wet weight of ileostomy fluid increased by 314 g/24 h and dry weight by 24 g/24 h after consumption of 15 g citrus pectin. During the pectin period there was a significant increase in the amount of nitrogen, fat, ash, Na and K found in ileostomy contents, while the amount of starch was unchanged. During the pectin period the apparent absorption of Fe decreased significantly, while that of P, Ca, Mg and Zn remained unchanged. It is concluded that there is only limited digestion of citrus pectin in the stomach and small intestine. The slight increase in ileal output of nitrogen may either be due to decreased digestion and absorption of fat is more pronounced. In the 3-d study addition of 15 g pectin to the diet did not seem to impair the apparent mineral absorption from the small intestine except in the case of Fe.

Experimental model for in vivo determination of dietary fibre and its effect on the absorption of nutrients in the small intestine.

1. An experimental model for the determination of dietary fibre according to the definition of Trowell et al. (1976) is described. Food was subjected to in vivo digestion in ileostomy patients, and the ileostomy contents were collected quantitatively, the polysaccharide components of which were analysed by gas--liquid chromatography and the Klason lignin by gravimetric determination. The model was used for the determination of dietary fibre in AACC (American Association of Cereal Chemists), wheat bran and for studies on the extent of hydrolysis of wheat-bran fibre in the stomach and small intestine. The effect of wheat bran on ileostomy losses of nitrogen, starch and electrolytes was also investigated. 2. Nine patients with established ileostomies were studied during two periods while on a constant low-fibre diet. In the second period 16 g AACC wheat bran/d was added to the diet. The ileostomy contents and duplicate portions of the diet were subjected to determinations of wet weight, dry weight, water content, fibre components, starch, N, sodium and potassium. 3. The wet weight of ileostomy contents increased by 94 g/24 h and dry weight by 10 g/24 h after consumption of bran. The dietary fibre of AACC bran, determined as the increase in polysaccharides and lignin of ileostomy contents after consumption of bran, was 280 g/kg fresh weight (310 g/kg dry matter). Direct analysis of polysaccharides and lignin in bran gave a value of 306 g/kg fresh weight. Of the added bran hemicellulose and cellulose 80--100% and 75--100% respectively were recovered in ileostomy contents. There was no significant difference between the two periods in amount of N, starch and K found in the ileostomy contents. The Na excretion increased during the 'bran' period and correlated well with the wet weight of ileostomy contents. 4. In conclusion, it seems probable that determination of dietary fibre by in vivo digestion in ileostomy patients comes very close to the theoretical definition of dietary fibre, as the influence of bacteria in the ileum seems small. Bacterial growth should be avoided by using a technique involving the change of ileostomy bags every 2 h and immediate deep-freezing of the ileostomy contents. True dietary fibre can be determined by direct analysis of polysaccharides and lignin in the food, at least in bran. Very little digestion of hemicellulose and cellulose from bran occurs in the stomach and small bowel. The 10--20% loss in some patients may be due to digestion by the gastric juice or to bacterial fermentation in the ileum, or both. The extra amount of faecal N after consumption of bran, reported by others, is probably produced in the large bowel.

The influence of the lipid composition of the feed given to mice on the immunocompetence and tumour resistance of the progeny.

In inbred CBA mice, the immunocompetence of adult progeny from breeding pairs fed three different diets was compared. Substitution of soy oil for animal fat in the feed of the mice during gestation or lactation significantly decreased the PFC response to SRBC in the adult offspring. Addition of 2-methoxy-substituted glycerol ethers to the feed of mothers deprived of animal fat during lactation partly restored the PFC response of the male offspring. In the adult mice fed differently pre- and perinatally the resistance to a transplanted syngeneic sarcoma was similar. The growth of offspring from mice fed the three diets was similar. In mice deprived of animal fat at weaning and for the following 21 days the immune reactivity to SRBC, tested about 3 months after stopping the diet, was not influenced. However, the resistance to a transplanted tumour in similarly fed mice was increased and this resistance was brought approximately to the control level by methoxy-substituted glycerol ethers.

Action on various experimental tumour-host systems of methyoxy-substituted glycerol ethers incorporated into the feed.

The effect of the growth and spread of tumours by methoxy-substituted glycerol ethers incorporated into the feed has been tested on a broad spectrum of tumour-host systems. Inhibitory effects on tumour growth were noted mainly by 1-0-(2-methoxy-hexadecyl) glycerol and on Melanoma B 16, Lewis Lung Tumour, MCA-sarcoma MCG101 and the lymphomas LAA and P1534. Spontaneous metastasis formation from Melanoma B16 and two MCA-sarcomas was inhibited.

Stimulation of immune reactivity by methoxy-substituted glycerol ethers incorporated into the feed.

In mice, the plaque-forming cell response to sheep red blood cells was stimulated by a mixture of methoxy-substituted glycerol ethers isolated from Greenland shark liver oil and by synthetic 1-0-(2-methoxyhexadecyl)-glycerol, given in the diet. In preliminary experiments, this synthetic compound also increased the ability of parental spleen cells to induce graft-vs.-host reactions in F1 hybrid mice. Glycerol ethers occur in the bone marrow fat of mammals and in the membrane phospholipids. It is postulated that the methoxy-substituted glycerol ethers supplied in the diet may stimulate the bone marrow and/or may be incorporated into membrane lipids, thereby changing the structure and function of the membranes.