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    Effects of Oral L-Glutamine, Insulin and Laxative on Bacterial Translocation in Acute Pancreatitis
    (2001) Avşar, Fatih Mehmet; Özel, İ. Hakan; Baykan, Mahmut; Saygun, Oral; Şahin, Mustafa; Hengirmen, Süleyman; Ertuğrul, Ömür; Gürbilek, Mehmet; Aydın, S. Neşe
    Aim: To investigate the effects of oral L-glutamine, insulin and laxative on the bacterial population of intestinal lumen and on bacterial translocation in acute pancreatitis. Materials and Methods: Forty Sprague-Dawley adult male rats were divided into 4 groups. Experimental pancreatitis was induced by ligating the main biliopancreatic duct. All groups were given the standard rat diet and tap water. In addition. Group II was given. 15 mg/kg/day of L-glutamine via a catheter enterally, Group III was given 3 ml of laxative via a catheter enterally, and Group IV was given 3 IU/kg/day of NPH insulin via a catheter enterally. The rats were sacrificed 96 hours after the induction of pancreatitis. Blood samples for biochemical analyses and blood culture, and culture samples from mesenteric lymph nodes, liver and spleen and from cecal content were taken. Aerobic and anaerobic cultures were prepared. Findings: Amylase levels in all the groups after the procedure increased significantly. Bacterial translocation was observed in 6 rats in the control group, in 5 rats in the insulin group, in 3 rats in the laxative group and in 2 rats in the L-glutamine group. A significant decrease in the number of luminal bacteria was observed in the laxative and L-glutamine groups. Conclusion: L-glutamine, administered in enteral solutions in rats with induced acute pancreatitis, may reduce septic complications by decreasing the bacterial translocation rate. Similar effects are also produced by laxatives through reduction in the luminal bacterial population.
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    Effects of Oral L-Glutamine, Insulin and Laxative on the Severity of Acute Pancreatitis
    (2001) Avşar, Fatih Mehmet; Şahin, Mustafa; Saygun, Oral; Özel, İ. Hakan; Hengirmen, Süleyman; Vatansev, Hüsamettin; Kafalı, Ertuğrul; Yılmaz, Osman
    Aim: To investigate the effects of oral L-glutamine, insulin and laxative on the severity of acute pancreatitis. Materials and Methods: Forty adult male Sprague-Dawley rats were divided into 4 groups. Experimental pancreatitis was induced by ligating the main biliopancreatic duct. All groups were given standard rat pellets and tap water. In addition Group II was given 15 mg/kg/day of L-glutamine via a catheter enterally, Group III was given a 3 ml/day fleet enema via a catheter enterally, and Group IV was given 3 IU/kg/day of NPH insulin via a catheter enterally. The rats were sacrificed 96 hours after the induction of pancreatitis. Blood samples for biochemical analyses, and tissue samples from the lung and pancreas for histopathological evaluation were taken. Findings: Significant increases in amylase levels were observed after the procedure. Five parameters in the L-glutamine group (BUN, glucose, leukocyte, pO2 and SGOT), 5 parameters in the laxative group (Amylase, BUN, glucose, LDH and SGOT), and 2 parameters in the insulin group (BUN and SGOT) were better than those in the control group. While necrosis was observed in 3 rats in the control group, 3 in the insulin group and in 1 in the laxative group in the histopathological evaluation of pancreas tissue, no rats in the L-glutamine group exhibited necrosis. More severe pancreatitis was observed in the control and insulin groups (p<0.05). Conclusion: L-glutamine, administered in enteral solutions in subjects with acute pancreatitis, will not increase the severity of pancreatitis, but will aid in meeting the energy demand of the subject. Laxative may also be employed in the removal of fecal mass during the early period of the disease.