Biomedical subjects

S Kulapongse

Publications and source records attributed to S Kulapongse.

9 recordsLinked to original sources

PubMed2001

Impact of liver cirrhosis on nutritional and immunological status.

The aims of the study were to determine the prevalence of protein calorie malnutrition (PCM) in Thai cirrhotic patients and to evaluate nutritional and immunological status in various stages of cirrhosis. Subjective Global Assessment (SGA) and anthropometric measurement were used as nutritional assessment in sixty cirrhotic patients. Delayed-type hypersensitivity skin test, lymphocyte count, immunoglobulin and complement were assessed for immune status. Blood samples were sent for routine tests, prealbumin, thiamine and riboflavin level. There were 7/60 (11.7%) patients with percentage of ideal body weight (%IBW) less than 90 per cent. SGA, hemoglobin, protein indices and cholesterol level showed the deterioration of nutritional status in the late stage of the disease. Five (8.3%) patients with thiamine deficiency, and thirteen (21.7%) patients with riboflavine deficiency were detected. Lowest levels of complement and highest levels of immunoglobulin also occurred in the late stage of the disease. In conclusion, defining %IBW <90 per cent as malnutrition, the prevalence of malnutrition in Thai cirrhotic patients was 11.7 per cent. Nutritional and immunological status deteriorated according to the advanced stage of disease. If nutritional support is given in the early stage, it may improve nutritional status and reduce morbidity and mortality in cirrhotic patients.

Adult↗

PubMed1999

Possible thermogenesis with dexfenfluramine.

Fifty obese patients with a body mass index greater than 25 kg/m2 were randomized into 3 groups: control (C = 19), placebo (P = 18) and dexfenfluramine (D = 18). A behavioral modification program which included eating habits, exercise, attitudes, social relationships and six steps to lifetime weight control was taught every week. All patients strictly followed the food manual and recorded their behavior, physical activity and food intake every day through 12 weeks. Placebo and dexfenfluramine 30 mg/day were given in a double blind placebo controlled study. The results showed that all 3 groups had significant decreases in rest times and increased activity times (p < 0.05) and significant reductions of the average total daily energy, carbohydrate and fat intake (p < 0.05). They all lost weight. Mean +/- SEM cumulative weight loss was 8.3 +/- 0.7 kg in group D, 3.3 +/- 1 kg, in group P and 2.9 +/- 0.7 kg, in group C. The mean additional weight loss of 5 kg, and 5.4 kg seen with dexfenfluramine being highly significant (p < 0.001) from group P and C most likely due to increased thermogenesis. Significant (p < 0.05) and gradual reduction of biceps, triceps skinfold and per cent body fat were constantly observed only in the dexfenfluramine group. There were no significant differences among the 3 groups regarding blood pressure, heart rate, hematologic, lipids and biochemical profiles.

Adolescent↗

PubMed1999

Serum copper and zinc levels in Thai patients with various diseases.

This study was conducted to evaluate the possible alteration of serum Cu and Zn levels in 118 medical inpatients (53 women and 65 men) in Ramathibodi Hospital. Patients were classified according to their main clinical diseases: pulmonary (n = 12), renal (14), infectious (30), malignant (9), cardiovascular (22), GI & hepatic (13) and hematological (18) diseases. Significantly increased serum Cu concentrations were found in patients with pulmonary, malignant, cardiovascular and infectious diseases; moreover, 75, 75, 50 and 37 per cent of these diseases, respectively, had serum levels greater than the normal mean + 2SD (23.6 mumol/L). Besides, 5 per cent of patients (3 in renal, 1 in infectious and 2 in GI & hepatic diseases) had low serum Cu levels suggestive of Cu depletion. By contrast, significantly decreased serum Zn concentrations were found in patients with GI & hepatic, infectious, renal, cardiovascular and malignant diseases. Serum Zn levels below the normal mean - 2SD (8.1 mumol/L) were presented in 46, 37, 29, 23 and 22 per cent of cases, respectively. It was found that serum Cu/Zn ratio in our patients not only with cancer but also with other diseases were statistically significant from the normal group. Hence, the use of serum Cu/Zn ratios as markers for the diagnosis of cancer or for staging tumors must be interpreted cautiously.

Adult↗

PubMed1998

Thiamin and riboflavin status of medical inpatients.

Thiamin status was assessed by erythrocyte transketolase activity (ETKA) and thiamin pyrophosphate effect (TPPE) and riboflavin status by erythrocyte glutathione reductase activity (EGRA) and activity coefficient (AC) in 165 medical inpatients in Ramathibodi Hospital. Based on TPPE > 15 per cent, 9 per cent of the medical inpatients had thiamin depletion. Most of them were patients with renal, cardiovascular, hematological and infectious diseases. Based on AC > or = 1.2, 17 per cent of these inpatients had riboflavin depletion. Most of them were patients with pulmonary, cardiovascular and hematological diseases. Only one patient with pulmonary disease had both thiamin and riboflavin depletion. The proportion of thiamin depletion (2/37) in subjects with thiamin supplementation (mean 32.4, median 6, mode 2 md/d) tended to be less than those without (9/98). But, subjects with riboflavin supplementation (mean 3.3, median 4, mode 1 md/d) had the proportion of riboflavin depletion (0/31) significantly (Z-test, p < 0.005) lower than without supplementation (23/104). The data suggested that although the usual dose of vitamin supplementation in medical inpatients is beneficial thiamin depletion can still be present in catabolic patients.

Adult↗

PubMed1995

Behavior modification in the treatment of obesity: acceptability profiles.

Seventy obese subjects, after receiving an 8-week group therapy program of behavior modification, showed that they had lost weight from fat tissue. There were significant decreases of per cent body fat, biceps, subscapular and iliac skinfold thickness while maintaining arm muscle area. There were significant decreases of both systolic and diastolic blood pressure during the program. The acceptability profiles of heart rate, liver and renal function test, fasting blood sugar, uric acid, serum iron, total iron binding capacity, minerals, electrolytes, hematological and lipid profiles were within normal limits before and after the treatment. The obese subjects rated the behavior modification program as more effective and indicated helpfulness of concepts, information and techniques of the program.

Adolescent↗

PubMed1992

Modification of erythrocyte membrane lipid composition induced by a single intravenous infusion of phospholipid-triacylglycerol emulsions in man.

The study aimed to investigate whether, during short term infusion of lipid emulsions in man, red blood cell (RBC) membrane lipid composition was altered and RBC-free cholesterol (FC) could serve as a source of FC accumulated in the plasma. 3 normal subjects were infused intravenously with either 10% Intralipid [10% IL; PL:triglyceride (TG) weight ratio of 0.12] at the rates of 0.1, 0.2 and 0.3 g TG.kg(-1).h(-1) (providing PL intakes of 12, 24, 36 mg.kg(-1).h(-1), respectively) or with 30% Intralipid (30% IL; PL:TG ratio of 0.04) at the rate of 0.3 g TG.kg(-1).h(-1) (providing 12 mg PL.kg(-1).h(-1)). Infusion of 10% IL at a slow rate and 30% IL at a high rate caused no change in RBC and plasma FC content. However, 10% IL infusion at intermediate and high rates induced a significant decrease in RBC-FC: PL ratio. This change was still present at 18 h after the cessation of high rate infusion. RBC-FC: PL ratio and plasma PL measured during infusion were significantly correlated (r = -0.87, p < 0.001). FC efflux from RBC appears to contribute to the rise in plasma FC. This study indicates that the excessive amount of PL present as liposomes in some intravenous lipid emulsions can alter erythrocyte membrane lipid composition.

Journal Article↗

PubMed1992

Effects of essential fatty acid contents of lipid emulsions on erythrocyte polyunsaturated fatty acid composition in patients on long-term parenteral nutrition.

The effect of the long-term intravenous infusion of 2 lipid emulsions, differing in essential fatty acid (EFA) content, on fatty acid pattern of red blood cell (RBC) was investigated in 5 patients with inflammatory bowel disease. They were randomly assigned to receive daily intravenous infusion of either a soybean emulsion or a mixed medium-chain triacyl-glycerols (MCT): soybean emulsion, followed by the other, each for a period of 3 months. The soybean emulsion contained exclusively long-chain triacylglycerols (LCT) with 54% of C18:2n-6 and 6% of C18:3n-3. The mixed emulsion consisted of a 50:50 (w:w) mixture of soybean LCT and MCT, providing half the amount of the same EFA compared to LCT emulsion. The same phospholipid emulsifier was used in both preparations. Infusion of LCT for a 3 month period modified RBC fatty acid pattern as follows: 18:2n-6 increased, 20:4n-6 decreased as well as n-6:n-3 ratio. By contrast, infusion of MCT/LCT did not alter RBC fatty acids, and even tended to correct a pattern altered by the previous LCT infusion. The study demonstrates that soybean LCT provides an excess of C18: 2n-6 which affects the balance between RBC fatty acids in adult patients. Decreasing the intake of C18:2n-6 and C18: 3n-3, by using a mixed MCT/LCT emulsion, appears more appropriate for keeping a balanced pattern.

Journal Article↗

PubMed1980

Assessment of nutritional status in adult hospitalized patients.

140 adult hospitalized Thai patients were assessed for their nutritional status. The prevalence of protein-calorie malnutrition in these patients based on various parameters was as follows: 73.2% according to weight-height, 80.0% accroding to triceps skinfold thickness, 60.7% according to upper arm muscle circumference, 50.4% according to hair root morphology and 66.2% according to serum albumin level. These data reflected the disproportionate loss of the patients' body tissues. Severity of protein-calorie malnutrition was also detected by physical signs. Anemia and vitamin deficiencies were present in some of the patients. This study signifies that intensive nutritional management should be done to combat hospital malnutrition.

Adolescent↗

PubMedDate not supplied

Plasma lipoprotein pattern during long-term home parenteral nutrition with two lipid emulsions.

Hypertriglyceridemia induced by short-term lipid infusions causes redistribution of neutral lipid components between endogenous lipoproteins and emulsion particles. To determine whether such redistribution occurs over a long-term infusion period and affects lipoprotein pattern, we studied seven patients with inflammatory bowel disease who received cyclic home parenteral nutrition for two consecutive periods of 3 months with two different lipid emulsions. During each period, they received in random order either an emulsion composed exclusively of soy-derived long-chain triglycerides (LCTs) or another emulsion containing an equal weight:weight mixture of long- and medium-chain triglycerides (MCTs/LCTs). Both emulsions contained 20 triglycerides (TGs) and 1.2 phospholipids. Lipids provided 50 of nonprotein energy. Blood samples were taken once a week, 1 hour before the end of infusion (during) and again after a 6- to 8-h lipid-free interval (baseline). During infusion, there was a moderate increase of plasma TGs and phospholipids and a slight decrease of plasma esterified cholesterol (CE) and free cholesterol. Most of the plasma TGs increase occurred in the very-low-density lipoprotein fraction (containing both emulsion particles and the endogenous very-low-density lipoprotein), but there was also an increase of TGs content in low-density lipoprotein (LDL) and high-density lipoprotein (HDL) that was more pronounced with MCTs/LCTs. Acquisition by exogenous particles of CE transferred from LDL and HDL was significant for the LCT emulsion only. Although no change was observed in plasma lipid concentration of baseline samples during 3 months of home parenteral nutrition, some modifications were observed in the composition of lipoprotein fractions demonstrating a redistribution of lipid components.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholesterol↗