• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.70-79
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• 2024

Backgrounds/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes. Methods: Data were extracted from the Recurrence After Whipple's study, a retrospective multicenter study of PD outcomes. Results: In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was "enteral only," "parenteral only," and "enteral and parenteral" in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m² (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN. Conclusions: A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.12
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• pp.1589-1598
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• 2008

The objective of this study was to investigate the effect of obesity on health by analyzing the factors which are related to obesity through the questionnaires on the dietary pattern, nutrient intake and physical measurements. The subjects, 419 college women aged 20 to 24 year-old, were randomly selected from Seoul and data were collected during March to May, 2008 and classified as under underweight, normal weight, and obesity groups according to BMI. However, weight, skeletal muscle mass, body fat mass, fat free mass, percentage of body fat, and waist to hip ratio showed significant differences among all the groups (p<0.05). In the obese group, 77.8% ate fat-rich foods such as galbi and samgyopsal more than two times per week, 66.7% ate vegetables other than kimchi (p<0.05) as compared to the underweight and normal groups by mini dietary assessment (p<0.05). The cholesterol intakes of the underweight, normal weight, and obese groups were $164.67{\pm}114.52mg/dL$, $143.31{\pm}99.58mg/dL$, and $121.92{\pm}54.91mg/dL$, respectively, and the obese group had a significantly lower intake than the other groups (p<0.05). The serum total cholesterol levels of the underweight, normal, and obese groups were $177.04{\pm}26.36mg/dL$, $189.46{\pm}29.05mg/dL$, and $170.00{\pm}12.75mg/dL$, respectively, and the obese group showed lower total cholesterol level than the other groups (p<0.05). The triacylglycerol level of the obese group ($132.00{\pm}64.60mg/dL$) was significantly higher than the other two groups (p<0.05). The HDL-cholesterol levels of the underweight, normal weight, and obese groups were $51.92{\pm}9.39mg/dL$, $59.20{\pm}13.53mg/dL$, and $43.00{\pm}8.98mg/dL$, respectively, showing that the obese subjects had significantly lower HDL-cholesterol levels as compared to the subjects in the other groups (p<0.05). The HDL-C/LDL-C ratios of the underweight ($0.52{\pm}0.45$) and normal weight ($0.59{\pm}0.23$) groups were higher than the ratio of the obese group ($0.41{\pm}0.06$). Total cholesterol were positively correlated with LDL-cholesterol (r=0.768, p<0.01), but triacylglycerol were adversely correlated with HDL-cholesterol. In conclusion, our results show that college-aged women in Seoul should be encouraged to amend their overall dietary habits, make a dietary plan that fits their individual needs, and maintain an effective exercise schedule.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.8
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• pp.1286-1293
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• 2004

This study was conducted to investigate the biological activity and hepatoprotective effect of various fractions and isolated compounds from Kochiae fructus (KF) extract on D-galactosamine (GaIN)-intoxicated rats. Male Sprague-Dawley rats were divided into control, GaIN treated group (GaIN), GaIN plus KF methanol extract treated group (KFM 200-GaIN), GaIN plus KF butanol extract treated group (KFB 200-GaIN), GaIN plus momordin Ic treated group (Momordin Ic 30-GaIN) and GaIN plus oleanolic acid treated group (Oleanolic acid 30-GaIN). KFM (200 mg/kg BW), KFB (200 mg/kg BW), momordin Ic (30 mg/kg BW) and oleanolic acid (30 mg/kg BW) were orally administered once a day for 14 days. GaIN (400 mg/kg BW) was injected at 30 minutes after the final administration of the compounds. The activities of serum aspartate aminotransferase and alanine aminotransferase were increased in the GaIN group compared to the control group and significantly lower in the KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group than in the GaIN group. Hepatic lipid peroxide level was increased in the GaIN group compared to the control group and was lower in the KFM 200-GaIN, KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group than in the GaIN group. Activities of xanthine oxidase and aldehyde oxidase in liver were higher in the GaIN group than in the control group and were significantly decreased in the KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group compared to the GaIN group. Hepatic glutathione, ${\gamma}$-glutamylcysteine synthetase and catalase activities were decreased in the GaIN group compared to the control group and were higher in the KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group than in the GaIN group. Activities of hepatic glutathione reductase, glutathione S-transferase, superoxide dismutase and glutathione peroxidase were lower in the GaIN group than in the control group and were improved in the KFM 200-GaIN, KFB 200-GaIN, momordin Ic 30-GaIN and oleanolic acid 30-GaIN group compared to the GaIN group. Therefore, the current results indicate that momordin Ic administration alleviated the GaIN-induced adverse effect through enhancing the antioxidant enzyme activities.

• The Korean Journal of Pharmacology
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• v.32 no.3
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• pp.407-416
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• 1996

The reactive intermediates formed during the metabolism of therapeutic agents, toxicants and carcinogens by cytochromes P450 are frequently capable of covalently binding to tissue macromolecules and causing tissue damage. It has been shown that YH439, a congener of malotilate, is effective in suppressing hepatic P450 2E1 expression. The present study was designed to further establish the mechanistic basis of YH439 protection against toxicant by assessing its effects against chemical-mediated potentiated hepatotoxicity. Retinoyl palmitate (Vit-A) pretreatment of rats for 7 days substantially enhanced carbon tetrachloride hepatotoxicity, as supported by an ${\sim}5-fold$ increase in serum alanine aminotransferase (ALT) activity, as compared to $CCl_4$ treatment alone. The elevation of ALT activity due to Vit-A was completely blocked by the treatment of $GdCl_3$ a selective inhibitor of Kupffer cell activity. Concomitant pretreatment of rats with both YH439 and Vit-A resulted in a 94% decrease in Vit-A-potentiated $CCl_4$ hepatotoxicity. YH439 was also effective against propyl sulfide-potentiated $CCl_4-induced$ hepatotoxicity. Whereas propyl sulfide (50 mg/kg, 7d) enhanced $CCl_4-induced$ hepatotoxicity by >5-fold, relative to $CCl_4$ treatment alone, concomitant treatment of animals with both propyl sulfide and YH439 at the doses of 100 and 200 mg/kg prevented propyl sulfide-potentiated $CCl_4$ hepatotoxicity by 35% and 90%, respectively. Allyl sulfide, a suppressant of hepatic P450 2E1 expression, completely blocked the propyl sulfide-enhanced hepatotoxicity, indicating that propyl sulfide potentiation of $CCl_4$ hepatotoxicity was highly associated with the expression of P450 2E1 and that YH439 blocked the propyl sulfide-enhanced hepatotoxicity through modulation of P450 2E1 levels. Propyl sulfide- and $CCl_4-induced$ stimulation of lipid peroxidation was also suppressed by YH439 in a dose-related manner, as supported by decreases in malonedialdehyde production. The role of P450 2E1 induction in the potentiation of $CCl_4$ toxicity and the effects of YH439 were further evaluated using pyridine as a P450 2E1 inducer. Pyridine pretreatment substantially enhanced the $CCl_4$ hepatotoicity by 23-fold, relative to $CCl_4$ alone. YH439, however, failed to reduce the pyridine-potentiated toxicity, suggesting that the other form(s) of cytochroms P450 inducible by pyridine, but not suppressible by YH439 treatment, may play a role in potentiating $CCl_4-induced$ hepatotoxicity. YH439 was capable of blocking cadmium chloride-induced liver toxicity in mice. These results demonstrated that YH439 efficiently blocks Vit-A-enhanced hepatotoxiciy through Kupffer cell inactivation and that the suppression of P450 2E1 expression by YH439 is highly associated with blocking of propyl sulfide-mediated hepatotoxicity.