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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vascular reconstruction for chronic intestinal ischemia can be accomplished by endarterectomy or aortomesenteric bypass. In our practice, antegrade bypasses from the supraceliac aorta to the celiac axis and superior mesenteric artery are currently the most frequently used techniques. Such reconstructions often use multiple or bifurcated large diameter vascular prostheses and have demonstrated excellent long-term patency. Despite these salutory results, we have noted an unusual perioperative response in three of these patients, which is the subject of this report. All three patients underwent uncomplicated elective mesenteric revascularization with grafts (diameter greater than or equal to 6 mm) originating in the supraceliac aorta. Indications for operation included (1) history of postprandial pain, (2) documentation of weight loss, and (3) angiographic evidence of advanced atherosclerotic disease with appropriate collateral development. Episodes of abdominal pain occurred 5 to 20 days after operation when normal food intake was reinstituted. In two patients immediate angiograms revealed patent grafts with diffuse mesenteric vasospasm. Treatment with intravenous hyperalimentation and nifedipine for 10 days resulted in complete resolution of symptoms. In the third patient, symptoms were totally relieved by temporary reduction in oral intake and administration of nifedipine. A later angiogram revealed a patent graft. All patients have remained asymptomatic and regained normal weight. This pattern of postrevascularization pain has not been seen in our patients undergoing revascularization with small (i.e., venous) conduits originating in the infrarenal aorta. The cause appears to be a heightened myogenic response of a "protected" vascular bed when suddenly exposed to the high perfusion pressure and blood flow of large caliber antegrade conduits. Prophylaxis with calcium channel blockers and use of smaller diameter grafts (5 mm) may avoid this disturbing syndrome.
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PMID:Postoperative vasospasm after antegrade mesenteric revascularization: a report of three cases. 188 Aug 46

The activity of tyrosine hydroxylase (TOH), the rate-limiting enzyme in norepinephrine biosynthesis, was measured in selected sympathetic ganglia to develop a quantitative measure of sympathetic autonomic neuropathy in streptozocin-induced diabetic rats. Surprisingly, TOH activity was elevated twofold in diabetic prevertebral ganglia innervating the alimentary tract (i.e., superior mesenteric, celiac, and inferior mesenteric), which has terminal processes that develop neuroaxonal dystrophy in this model system. TOH activity of paravertebral ganglia (i.e., superior cervical and stellate) with nonalimentary targets was not increased in the same animals. Increased TOH activity in the prevertebral ganglia 1) developed within the 1st wk of diabetes and persisted for 10 mo, 2) did not represent a change in TOH affinity for d-1,6-methyl-5,6,7,8- tetrahydropterine cofactor, 3) was prevented by both nicotinamide pretreatment and early institution of insulin therapy, and 4) did not develop as a result of classical transsynaptic induction. Pair-feeding experiments confirmed that the most likely cause of increased TOH activity in this system was the marked hypertrophy and hyperplasia of the diabetic bowel resulting from compensatory hyperphagia. We conclude that TOH activity does not represent a suitable marker for sympathetic autonomic neuropathy in this experimental system. Rather, the increase appears to be an example of a selective increase in the synthesis of neurotransmitter enzymes, possibly in response to increased trophic support provided by the expanded target, i.e., the hypertrophic gut. The additional synthetic stress imposed on prevertebral neurons by the expansion of the innervation of the alimentary target coupled with the complex diabetic metabolic milieu may contribute to the development and selective distribution of dystrophic axonopathy to the innervation of the alimentary tract.
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PMID:Tyrosine hydroxylase activity in sympathetic nervous system of rats with streptozocin-induced diabetes. 256 57

Diet therapy is an important factor in overall care of most GI patients. Historically, diets have been used unscientifically in many of these patients without positive results. Nutritional care and diet therapy are critical for two reasons. First, malnutrition is an expected sequelae to most, if not all, GI diseases or disorders. Failure to eat, digest, or assimilate nutrients can provoke malnutrition in just a few weeks, although careful assessment of anthropometric, clinical, biochemical, and nutritional history by a trained professional can protect against this. Diet therapy through the elimination of offending foods such as wheat gluten or lactose, or inclusion of specialized products such as medium chain triglycerides or elemental formulas, can sustain nutritional status. Dietary components such as insoluble fiber appear to have physiologic effects, while soluble fibers may have metabolic effects important to diabetes and cardiovascular disease. There is a high potential for malnutrition in Crohn's disease during active and remittent phases. Elemental enteral formulas or TPN are used during the active phase to ensure optimal nutritional status and bowel rest. Hyperalimentation using the GI tract during remittent stage maintains this. Avoiding offending foods by Crohn's patients is an acceptable practice as long as entire categories of foods are not deleted. Avoiding all foods containing gluten from wheat, rye, barley, and oats, however, is a crucial prerequisite to recovery from celiac disease. Gluten is commonly used as a stabilizer, emulsifier, and extender in the food industry and is not always shown on food labels. Careful consultation with a registered dietitian can identify hidden sources of gluten in the diet.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dietary therapy in gastrointestinal disease. 264 90

Heterotopic liver transplantation utilizing intraportal hyperalimentation was studied in dog for the purpose of temporary hepatic support for acute liver failure. The liver graft was transplanted in the right lower abdomen of the recipient, and its suprahepatic IVC was anastomosed end-to-side to the infra-renal IVC of the recipient. The celiac artery of the graft was anastomosed end-to-end to the right internal iliac artery of the recipient. An infusion catheter was placed in the donor's portae and intraportal hyperalimentation with insulin was performed. A polyethylene tube (1.7 mm bore) was inserted into the CBD of the graft and led through the body wall as an external biliary drain, after which the recipient's CBD was ligated and transected. The grafts functioned well and excreted bile for 6 days in a non-immunosuppressed group and until death in an immunosuppressed group. Serum bilirubin levels of the recipients increased slightly or were within normal range. At autopsy, the grafts showed no atrophy. Heterotopic liver transplantation with intraportal hyperalimentation will be useful as a temporary hepatic support for acute liver failure in the future.
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PMID:[Heterotopic liver allotransplantation in dogs utilizing intraportal hyperalimentation]. 308 6

Six patients with hyperphagia (ingestion of 5-11 000 Kcals/day) associated with severe malabsorption and steatorrhoea are described. The cause of the malabsorption was coeliac disease in three patients, Crohn's disease with ileal resection in two, and carcinoma of the pancreas in one patient. There was no evidence of neurological or endocrine disease (apart from mild diabetes mellitus in the patient with carcinoma of the pancreas) but three patients suffered from severe depression. This association may be commoner than previously realized and be revealed in patients with steatorrhoea of unexplained severity by careful dietary assessment. Its detection has therapeutic implications since restriction of caloric and fat intake decreased steatorrhoea without weight loss in several of the patients described.
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PMID:Hyperphagia in intestinal disease. 453 69

Sectioning the hepatic branch of the anterior abdominal vagal trunk attenuated but did not abolish the normal nocturnal bias in the day-night distribution of food intake in female rats. Neither total daily food intake nor body weight was affected by hepatic vagotomy. This effect appeared to be specific to the hepatic branch of the nerve because sectioning the remaining (gastric and celiac) abdominal vagal branches did not influence daily feeding rhythms and appeared to be specific to feeding behavior, because the day-night rhythms of drinking behavior and wheel-running activity were not affected by hepatic vagotomy. In male rats, hepatic vagotomy also produced an increase in daytime food consumption but without commensurate reduction in nighttime eating. As a result, male rats with hepatic vagotomy displayed a modest chronic hyperphagia and body weight gain, which was associated primarily with increased linear growth. The effect of nerve section on daytime food intake was expressed quite rapidly. Daytime food intake increased within 8 h after hepatic vagotomy, which was produced at light onset by pulling on a previously implanted suture. Collectively, these results demonstrate that hepatic vagotomy changes daily feeding rhythms and suggest that the liver and perhaps its vagal innervation are involved in the control of ad libitum eating behavior.
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PMID:Evidence for hepatic involvement in control of ad libitum food intake in rats. 674 19

The ingestive responses of rats given celiac vagotomy (C), combined celiac and hepatic vagotomy (CH), or low total vagotomy (removal of all tissue from around the esophagus, stomach and duodenum; LT) were compared with sham operated controls (S) in a series of regulatory challenges. The vagotomized groups responded normally to 2-deoxy-D-glucose (2DG; 125, 250, 500 mg/kg, IP), insulin (4, 8, 12 U/kg, IP), and polyethylene glycol (10 ml/kg: 30% w/v, SC), but displayed attenuated responses to epinephrine (40, 80, 120 micrograms/kg, IP) and hypertonic saline (10 ml/kg: 0.25, 0.5, 1.0 M, IP). These results can be interpreted as evidence that the celiac vagus carries a major component of hepatic afferent innervation. Additionally, when considered with other findings they suggest that whereas the anorectic activity of epinephrine is mostly confined to the liver, 2DG hyperphagia involves stimulation of a wider population of peripheral metabolic receptors.
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PMID:Celiac vagotomy attenuates the ingestive responses to epinephrine and hypertonic saline but not insulin, 2-deoxy-D-glucose, or polyethylene glycol. 675 89