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乳び尿症におけるMedium Chain Triglycerideの使用経験

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Title: 乳び尿症におけるMedium Chain Triglycerideの使用経験
Other Titles: Treatment of Filarial Chyluria with Medium Chain Triglyceride
Authors: 村上, 文也 / 中島, 康雄 / 原田, 尚紀 / 白石, 篤与 / 牟田, 直矢 / 岩本, 功 / 赤嶺, 達生 / 木村, 英作
Authors (alternative): Murakami, Fumiya / Nakajima, Yasuo / Harada, Takanori / Shiraishi, Atsuyoshi / Muta, Naoya / Iwamoto, Isao / Akamine, Tatsuo / Kimura, Eisaku
Issue Date: 30-Sep-1972
Publisher: 長崎大学熱帯医学研究所 / Institute of Tropical Medicine, Nagasaki University
Citation: 熱帯医学 Tropical medicine 14(3). p138-143, 1972
Abstract: Chyluria is a condition characterized by the passage of milky urine resulting from an abnormal connection between the intestinal lymphatic drainage and the urinary tract. Within a few hours after ingestion of a meal in which fat is present such a person often passes milky in appearance urine containing a portion of the chyle. It is, however, very difficult for the patient to adhere to a low fat diet using ordinary foods. The availability of Medium Chain Triglyceride (MCT) appears to offer a new approach to the management of such disorder as chyluria, because MCT contains only fatty acids with a chain length lower than laurate (C 12:0) and it is absorbed rather through portal vein than through the lymphatics. This paper reports the results of studies involving long-term administration of low fat diet supplemented with a synthetic MCT to 5 patients with chyluria who were admitted into our department. The subjects were maintained on a formula diet contained 5 g of fat supplemented with 100 g of MCT. As the result, 3 out of 5 patients showed marked improvement, urine becoming clear and protein-free in 2 to 29 days after the start of treatment. Despite the presence of trace amounts of long chain fatty acids in the diet the patients continued to be free of symptoms, and at no time was the urine grossly chylous. The other 2 cases with severe changes in lymphangiogram have taken the same diet without benefit over two months. In all cases no serious side effect due to MCT was detected. The mechanism of effect of MCT is not clear, but it seems likely that prolonged MCT feeding is associated with decreased formation and flow of intestinal lymph, with a diminution in the shunting of lymph into the urine. It is suggested that diets containing MCT as the source of fat can be useful in the clinical management of patients with various forms of chylous fistulas such as chyluria. Further studies into this problem are necessary.
URI: http://hdl.handle.net/10069/4119
ISSN: 03855643
Type: Departmental Bulletin Paper
Appears in Collections:Volume 14, No. 3

Citable URI : http://hdl.handle.net/10069/4119

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