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Objective: To clarify the factors responsible for a reduction in eating and swallowing functions during hospitalization among patients who underwent surgery for proximal femoral fracture?
Subjects and Methods: The study subjects comprised 26 patients who underwent surgery for proximal femoral fracture in our hospital. With the food texture during hospitalization used as an index of the eating and swallowing functions, the subjects were divided into patients whose food texture did not change during hospitalization (group A), and patients who required thickened liquids or other changes in their food texture during hospitalization (group B).
Results: C-reactive Protein (CRP) levels on admission and the rate of hospitalization from nursing homes were significantly higher in Group B compared with Group A (p=0.04 and p=0.03, respectively). Although there were no significant differences between the groups with serum Albumin (Alb) levels and Body mass index (BMI) on admission (p=0.08 and p=0.08, respectively), these values tended to be lower in Group B.
Conclusion: The eating and swallowing functions are more likely to decline during hospitalization in patients who have been hospitalized from nursing homes, those with inflammation, and those with suspected malnutrition as suggested by low Alb levels or BMI on admission, and, thus, special attention should be paid to these patients.

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Background: A retrospective study was performed to assess the effectiveness and safety of pancrelipase for digestive and absorption disorders in patients after gastrectomy.
Methods: Between August 2012 and March 2013, patients who had undergone total or distal gastrectomy at least 1 year ago, had lost more than 5% of their body weight and had been prescribed received the prescription of pancrelipase 1.8g/day for >1 year were identified from the clinical records in the Cancer Institute Hospital. Differences in body weight and nutritional indicators were estimated before and after pancrelipase administration.
Results: Sixty-two patients with gastric cancer were identified: 23 had undergone total gastrectomy and 39 had undergone distal gastrectomy. Drug compliance was 86.3%. Average body weight of patients who underwent total gastrectomy increased significantly from 52.6 kg to 53.6 kg after administration (p= 0.034), but there was no significant change in mean body weight after distal gastrectomy. There was a significant change in serum albumin levels in patients who underwent either total or distal gastrectomy. Moreover some patients reported improvements in subjective symptoms, such as diarrhea and loss of appetite following pancrelipase administration. In Four patients (6.5%) reported adverse events, such as nausea, diarrhea and skin itchiness, although all symptoms were mild (Grade 1).
Conclusion: Administration of pancrelipase may be a promising intervention for digestive or absorption disorders in malnourished patients after gastrectomy.

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Objectives: The aim of this study was 1) to evaluate the physical properties in a low pH environment, 2) to reveal gastrointestinal dynamics, 3) and to assess nutritional status of rats after administration of a novel liquid enteral nutrition containing pectin (P-EN).
Methods: 1) The viscosity of P-EN was tested over time by mixing with simulated gastric juice. 2) After P-EN was administrated to gastrostomized rats, the residual ratio in the stomach and the travelling rate in the small intestine were measured. 3) After feeding rats a fixed calorie amount of P-EN for 2 weeks, we conducted a blood test, and evaluated body weight and nitrogen balance.
Results: 1) The viscosity of P-EN increased proportionately at pH4.7 and less. 2) P-EN turned into a gel in stomach, and showed a high residual ratio and low travelling rate in the small intestine in rats. 3) Administering P-EN in a fixed caloric amount did not result in any abnormal blood test values and no difference in nitrogen balance compared with calorie-matched control.
Conclusion: We confirmed the gelation of P-EN in a low pH environment. Furthermore, gelation was also observed in the rat stomach. Gastrointestinal dynamics of P-EN were similar to that of semi-solid diet. The results indicate that P-EN can be administered as a comprehensive nutritional diet.

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Aims: To ascertain whether peripheral parenteral nutrition with a high-ratio lipid emulsion can be used safely.
Methods: The participants of this study were adult patients (n = 100) who required bowel rest. The nutrition dosage was determined based on the required energy level and amount of lipid emulsion per kg body mass, as calculated using the Harris-Benedict equation. Factors that were used to evaluate the usage safety included changes in parameters such as lipid levels, inflammatory reactions, liver function, and the presence or absence of adverse events. Hematological parameter was collected before commencing and after completion of peripheral parenteral nutrition.
Results: The average age of the patients was 71 years, average total energy dosage was 1,352 kcal/day, proportion of the total energy obtained from lipids was 60.9%, and average administration duration was 6.8 days. The levels of triglyceride and total cholesterol did not change significantly before and after nutrition dosage. Fasting blood glucose levels, prothrombin times, leukocyte and neutrophil counts, and bilirubin levels were decreased after dosage, compared with those before. No adverse events due to lipid emulsion were observed.
Conclusions: Lipid emulsions comprising 60% of the total energy dosage can be safely administered over a course of 1 week, causing no large changes in lipid metabolism.

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