P.35 Selenium status in patients receiving home parenteral nutrition (HPN)

JS IN PATIENTS RECEIVING HOME PARENTERAL NUTRITION (HPN). C.R. Flemin 9, I.F. O'Br ien~ R.W. Forsman~ J. Petz (Mayo C l i n i c , Rochester , Minnesota

Is a component o f g l u t a t h i o n e perox idase (GSH-Px), an enzyme tha t c a t a l y - la t ion of o rgan ic hydroperox ides and hydrogen pe rox ide . In the absence of pxides and f ree r a d i c a l s may damage c e l l membranes. Several animal models cy and card iomyopathy and at l eas t two cases of p a t i e n t s on HPN who have ,myopathy and severe Se d e f i c i e n c y have been repo r ted . Our one f a t a l i t y e i ng assoc ia ted w i th Se d e f i c i e n c y prompted us to determine serum and y Se concen t ra t i ons in p a t i e n t s before and dur ing HPN and to c o r r e l a t e whole blood GSH-Px a c t i v i t i e s and du ra t i on of HPN. Twelve p a t i e n t s p r i o r N and 26 d i f f e r e n t p a t i e n t s on HPN from 2 to 109 months (~ 29) were ents w i th Crohn's d isease (n :30) not on HPN and h e a l t h y adu l ts served as l e v e l s in the HPN s o l u t i o n s were <I ug/2000 cc.

Se Group n Serum Ur i ne

ng/ml ~g/d Pre-HPN 12 42 + 38 6 HPN 26 "I"38 ¥ 30~'~8 ~ ~8~/,~ ~ Crohn's 30 ~76 ¥ 1 5 C j * Health 27 88 ¥

*p <.001 cent (11/12) of patients pre-HPN and 85% (22/26) of patients on HPN had alues. A significant correlation existed between serum Se values and ies; the correlation was greatest for HPN patients with Crohn's disease ). A significant inverse correlation existed between serum Se and months ents with Crohn's disease (r= -.85, p <.01). Se deficiency is very common g and during HPN.

,MIN A ON HEALING OF COLON ANASTOMOSIS. S. ,Bark, G. Rettura~ D. Goldman, M. Levenson & A.A, Demetriou (Department of Surgery, Albert Einstein icine - Montefiore Medical Center, Bronx, New York, USA)

d i e t a r y supp lementa t ion w i th v i t am in A on the hea l i ng of colon anastomosis i f t y adu l t male ra ts were d i v ided i n t o two groups: 1/ Rats fed a standard w con ta in i ng more than twice the d a i l y US Nat l . Res. Counci] recommended i tamin A; 2 / Rats fed the same chow supplemented w i th 150 IU v i tam in A/g were prefed f o r f i v e days; on day 6, they underwent a m id l i ne abdominal p e n t o b a r b i t a l anes thes ia ; the colon was d i v i ded one inch d i s t a l to the

t i on and then reanastomosed. The rats were main ta ined on the above d i e~ and k i l l e d on the 6th pos tope ra t i ve day w i th e t he r . The segment of colon

anastomosis was resected. In 15 rats from each group, the resected co lon ong the mesenter ic border , and i t s breaking s t reng th was measured. In the ats from each group, the bu rs t i ng s t reng th of the anastomosed segment and ormal colon (ad jacent and d i s t a l to the anastomosed segment) was measured. on from the anastomosis and the normal segment were analyzed f o r hydroxy-

was a s i g n i f i c a n t decrease in hyd roxyp ro I i ne content at the anastomot ic ared to the normal d i s t a l colon s i t e in each group of ra ts (p<O.0l) . The

content of both the normal colon and the ~nastomosis was s i g n i f i c a n t l y v i t a m i n A supplemented rats (p<0 ,0 i ) . There was a s i g n i f i c a n t increase in gth in the v i t am in A supplemented rats both in the anastomosed segment n the normal segment (p<0.Ol) . The anastomot ic break ing s t reng th peak

d i f f e r s i g n i f i c a n t l y between the groups but the b reak ing s t reng th curve rats was narrow w i th a sharp peak, whereas, t ha t of the v i tam in A supple-

s wide w i th a smooth, b lunt peak. The area under the break ing s t reng th ured by p Ian ime t r y was th ree t imes g rea te r in the v i t am in A supplemented he con t ro l ra ts (p~O.001). We conclude tha t v i t am in A supplementat ion has f f e c t on hea l i ng of colon anastomosis in ra ts .