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JS IN PATIENTS RECEIVING HOME PARENTERAL NUTRITION (HPN). C.R. Flemin 9, I.F. O'Brien~ R.W. Forsman~ J. Petz (Mayo Clinic, Rochester, Minnesota Is a component of glutathione peroxidase (GSH-Px), an enzyme that cataly- lation of organic hydroperoxides and hydrogen peroxide. In the absence of pxides and free radicals may damage cell membranes. Several animal models cy and cardiomyopathy and at least two cases of patients on HPN who have ,myopathy and severe Se deficiency have been reported. Our one fatality eing associated with Se deficiency prompted us to determine serum and y Se concentrations in patients before and during HPN and to correlate whole blood GSH-Px activities and duration of HPN. Twelve patients prior N and 26 different patients on HPN from 2 to 109 months (~ 29) were ents with Crohn's disease (n:30) not on HPN and healthy adults served as levels in the HPN solutions were <I ug/2000 cc. Se Group n Serum Uri ne ng/ml ~g/d Pre-HPN 12 42 + 38 6 HPN 26 "I"38 ¥ 30~'~8 ~ ~8~/,~ ~ Crohn's 30 ~76 ¥ 15Cj* 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) dietary supplementation with vitamin A on the healing of colon anastomosis ifty adult male rats were divided into two groups: 1/ Rats fed a standard w containing more than twice the daily US Natl. Res. Counci] recommended itamin A; 2/ Rats fed the same chow supplemented with 150 IU vitamin A/g were prefed for five days; on day 6, they underwent a midline abdominal pentobarbital anesthesia; the colon was divided one inch distal to the tion and then reanastomosed. The rats were maintained on the above die~ and killed on the 6th postoperative day with ether. The segment of colon anastomosis was resected. In 15 rats from each group, the resected colon ong the mesenteric border, and its breaking strength was measured. In the ats from each group, the bursting strength of the anastomosed segment and ormal colon (adjacent and distal to the anastomosed segment) was measured. on from the anastomosis and the normal segment were analyzed for hydroxy- was a significant decrease in hydroxyproIine content at the anastomotic ared to the normal distal colon site in each group of rats (p<O.0l). The content of both the normal colon and the ~nastomosis was significantly vitamin A supplemented rats (p<0,0i). There was a significant increase in gth in the vitamin A supplemented rats both in the anastomosed segment n the normal segment (p<0.Ol). The anastomotic breaking strength peak differ significantly between the groups but the breaking strength curve rats was narrow with a sharp peak, whereas, that of the vitamin A supple- s wide with a smooth, blunt peak. The area under the breaking strength ured by pIanimetry was three times greater in the vitamin A supplemented he control rats (p~O.001). We conclude that vitamin A supplementation has ffect on healing of colon anastomosis in rats.

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

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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 .