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Background: Term infants can be categorized into 3 sub-groups: early term (37w0d to 38w6d), full term (39w0d to 40w6d), and late term (41w0d and beyond). However, the fatty acid composition among the 3 groups of term infants has not been investigated. The association between fatty acid composition and gestational period of term infants in Japan is unclear. Methods: We assessed the fatty acid composition of maternal erythrocyte membranes in the third trimester and of cord erythrocyte membranes at birth in 212 healthy term Japanese infants using data from a prospective hospital-based cohort study. Results: In maternal erythrocyte membranes, docosahexaenoic acid (DHA) levels and omega-3 index were significantly higher in the late-term group than in the early-term group. In cord erythrocyte membranes, DHA levels were not significantly different between the 3 groups; late-term infants showed significantly higher DHA/arachidonic acid (ARA) and lower 20: 3n-6 and ARA levels compared to early-term infants. Gestational period positively correlated with the DHA status in maternal and cord erythrocyte membranes. Conclusions: Fatty acid composition in maternal and cord erythrocyte membranes varies between early-, full-, and late-term infants, and the greater gestational period may contribute to the relatively high n-3 polyunsaturated fatty acids status in term infants. Furthermore, maternal DHA status in the third semester directly correlates with gestational period in pregnant Japanese women.

In recent years, Oral Immunotherapy(OIT)for food allergies has received a lot of attention. The aim of this study is to examine the effects of the treatment through research into the quality of life(QOL)of children with food allergies and their parents, and to explore the role of registered dietitians(RD)in the course of their therapy. Two validated food allergy-specific questionnaires(FAQLQ-CF and FAQLQ-PF)were distributed to 42 children with food allergies and their 42 parents respectively before children began an OIT protocol in hospital, and then again 6 months and 12 months after completing the protocol. Valid answers of 33 children and their 33 parents were analyzed. The results of the questionnaire revealed that the QOL as related to food of the children with food allergies and their parents had changed from the beginning of the protocol, and these benefits were still evident twelve months later. Especially, significant improvement was found in the "social anxiety" of 9 children who had eliminated only one food and also in their 9 parents. The children's eating habits had improved. And generally the OIT had positive effects on allergic children and their parents. But the researchers could not detect whether the children had enjoyed eating the foods they were allergic to during the therapy. RDs, who have acquired professional food expertise, have usually worked helping the patients and parents to avoid allergenic foods, but for those who undergo OIT protocol, they need to give advice and more detailed support to the children and parents on how to eat the allergenic food properly during and after their therapy.

Objective: Docosahexaenoic acid (DHA) is an important nutrient required by pregnant women and fetuses. Several studies suggest that fatty acid composition changes during pregnancy. However, the association of longitudinal changes in erythrocyte fatty acid composition and dietary fatty acid intake during pregnancy is not well understood. We assessed the relationship between fatty acid composition of the erythrocyte membranes and fatty acid intake at each trimester in pregnant Japanese women. Methods: We conducted a prospective hospital-based cohort study. We investigated fatty acid composition of the erythrocyte membranes and intake of fatty acids during the three trimesters in 178 healthy, pregnant Japanese women. Results: The eicosapentaenoic acid and arachidonic acid percentage of the erythrocyte membranes significantly decreased. The percentages of linoleic acid and α-linolenic acid significantly increased during pregnancy. The DHA percentage in the erythrocyte membranes decreased from the second to the third trimester. The DHA percentage in the erythrocyte membranes positively correlated with DHA intake in the third trimester. Conclusion: In pregnant Japanese women, the fatty acid composition of the erythrocyte membranes markedly changed throughout pregnancy. The DHA intake in the third trimester may be insufficient to maintain DHA percentage in the maternal erythrocyte membranes.

咀嚼・嚥下機能低下者に対応する食品の基礎的研究として，固体分散ペーストの摂食量が咽頭部通過時の食塊の移動速度に与える影響について超音波パルスドップラ法，嚥下造影法および官能評価により検討し，以下の結果を得た．機器測定においてはキサンタンガムペースト添加を除く他の試料において摂食量が増加すると硬さは高くなる傾向がみられた．官能評価においてはグアーガム，キサンタンガムペースト添加試料は摂食量の影響を受けにくかったが，摂食量が増加すると付着しやすさの評価は高くなった．食塊の最大移動速度は5回咀嚼，30回咀嚼ともに，水添加，澱粉ペースト添加は，摂食量が増加するに従って速くなる傾向がみられ，摂食量の影響を受けやすい試料であったが，グアーガム，キサンタンガムペースト添加試料は，摂食量に影響を受けず，ほぼ一定の速度であった．通過時間においては，食塊が液体的な場合は摂食量の増加に伴い通過時間が長くなる傾向がみられたが，食塊が固体的で粘稠な場合は，液体的試料よりも摂食量増加の影響を受けにくかった．固体分散ペーストの摂食量の影響は，添加するペーストの力学特性値が関与する可能性が高いと推察された．

寒天ゲルとゼラチンゲルの摂取量および咀嚼回数が，食塊の咽頭部通過時における移動速度と食塊の力学特性に及ぼす影響を，超音波パルスドップラー法，テクスチャー測定ならびに官能評価により検討し，以下の結果を得た．寒天ゲルの硬さは，摂取量が少なく，咀嚼回数が多くなるほど低下し，ゼラチンゲルの硬さは口腔内停滞時間の長い，30回と50回咀嚼で低下し，摂取量の影響は小さかった．最大速度について，寒天ゲルで高い値を示したのは5回咀嚼の9gと12gにおいてであり，ゼラチンゲルでは，50回咀嚼の3gと6gであった．これらの結果には，寒天ゲルでは主に咀嚼によって破砕された食片の大きさと量が影響しており，ゼラチンゲルでは咀嚼後の融解の程度が主に影響していると推察された．

We evaluated the infection risks in the neonatal intensive care unit (NICU) using data of NICU infection surveillance data. The subjects were 871 NICU babies, consisting of 465 boys and 406 girls, who were cared for between June 2002 and January 2003 in 7 medical institutions that employed NICU infection surveillance. Infections were defined according to the National Nosocomial Infection Surveillance (NNIS) System. Of the 58 babies with nosocomial infections, 15 had methicillin-resistant Staphylococcus aureus (MRSA) infection. Multiple logistic regression analysis demonstrated that the odds ratio for nosocomial infections was significantly related to gender, birth weight and the insertion of a central venous catheter (CVC). When the birth weight group of more than 1, 500 g was regarded as the reference, the odds ratio was 2.35 in the birth weight group of 1,000-1,499 g and 8.82 in the birth weight group of less than 1,000g. The odds ratio of the CVC (+) for nosocomial infection was 2.27. However, other devices including artificial ventilation, umbilical artery catheter, umbilical venous catheter, and urinary catheter were not significant risk factors. The incidence of MRSA infection rapidly increased from 0.3% in the birth weight group of more than 1,500 g to 2.1% in the birth weight group of 1,000-1,499 g, and to 11.1% in the birth weight group of less than 1,000g. When the birth weight group of more than 1,500 g was regarded as the reference, multiple logistic regression analysis demonstrated that the odds ratio was 7.25 in the birth weight group of 1,000-1,499 g and 42.88 in the birth weight group of less than 1,000g. These odds ratios were significantly higher than that in the reference group. However, the application of devices did not cause any significant differences in the odds ratio for MRSA infection.

Background: There have been few studies of the thyroid stimulating hormone (TSH) surge in extremely low-birthweight (ELBW) infants, and the relationship between thyroid hormones and respiratory distress syndrome (RDS) has yet to be clarified. The present study sought to determine the serum levels of free T4 (fT4) and TSH in ELBW infants and to examine the relationship between these levels and the development of RDS. Methods: The authors measured serum fT4 and TSH levels soon after birth in 449 preterm infants, who were born at 22–36 weeks of gestation, and determined the associations between these levels, the incidence of RDS, and the recognized clinical factors associated with RDS. Results: Serum fT4 and TSH levels, and the fT4/TSH ratio, in the group at 22–24 weeks of gestation were significantly lower than those in the group at 28–36 weeks. The levels and ratio increased significantly with increasing gestational age. There were significant correlations between the serum fT4 level and the birthweight, Apgar score, and gender, and between the serum TSH level and the gestational age, mode of delivery, and birthweight. No significant relationship between the incidence of RDS and the serum levels of fT4 and TSH was observed. Conclusion: The authors’ results suggest that the serum levels of fT4 and TSH in ELBW infants are very low, and that these levels are not correlated with the occurrence of RDS.

Background: Phospholipids (PLs) play an essential role in the growth and brain development of infants. Aim: To investigate PL composition in human milk (HM), including lysophosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, phosphatidylserine, phosphatidylcholine (PC) and sphingomyelin (SM), from healthy Japanese mothers. Analyses were performed on colostrum, transitional milk and mature milk from mothers of preterm and term infants. Methods: HM samples were collected from mothers of 15 term infants (term group) and of 19 preterm infants (preterm group). PL composition was determined by two-dimensional thin-layer chromatography in conjunction with phosphorus analysis. Results: In both groups, the PL content (% of total lipid) of mature milk was significantly lower than in colostrum. SM and PC were the main PLs in HM, but in the preterm group, the percentage of SM in mature milk was significantly higher and PC in mature milk was significantly lower than in the term group. Conclusion: The transition from colostrum to mature milk leads to an increase in SM and a decrease in PC in the HM of preterm infants, along with a decrease in PL content. This is the first report to demonstrate the differences in PL composition in HM between mothers of preterm and term infants.

Very low birth weight (VLBW) infants are known to have poorly developed antioxidant system and may be at increased risk for radical damage. Previous studies have reported higher levels of lipid peroxide products in lipid emulsion used for parenteral nutrition. To examine the direct effects of parenteral lipid infusion on DNA damage in VLBW infants, we measured urinary 8-hydroxydeoxyguanosine (8-OHdG) levels in VLBW infants before, during, and after the parenteral lipid infusion. In both the lipid-infused and lipid-free groups, urinary 8-OHdG excretion levels at 14 days old were significantly (p < 0.01) lower than those at 2 and 7 days old. However, there were no significant differences in urinary 8-OHdG excretion levels between the lipid-infused and lipid-free groups at 2, 7, and 14 days old. Our results suggest that parenteral lipid infusion does not cause oxidative DNA damage, but irrespective of the infusion DNA damage during the first week of life is enhanced when compared with 14 days after birth in VLBW infants.

Aim: Glicentin, an active component of enteroglucagon, is considered to have a significant trophic action on the intestinal mucosa. We examined the effects of extremely early enteral feedings on the postnatal and postprandial changes in plasma glicentin levels in very-low-birthweight (VLBW) infants. Methods: We measured the plasma glicentin concentrations before and after feedings at 1 or 2 days, 5 or 6 days and 14 days after birth in 21 VLBW infants. The subjects were randomly divided into an extremely early feeding group, which was started on breast milk within 24 h after birth, and a control group, which was started on breast milk more than 24 h after birth. Results: Plasma basal concentrations of glicentin at 5 or 6 days and at 14 days after birth were significantly higher than those at 1 or 2 days after birth in the early feeding group. The basal glicentin level at 14 days after birth was significantly higher than that at 1 or 2 days. The basal levels at 5 or 6 days and at 14 days after birth in the early feeding group were significantly higher than those in the control group. Plasma glicentin concentrations after feeding were significantly higher than those before feeding at 5 or 6 days and 14 days after birth in the early feeding group, but those levels were significantly higher only at 14 days after birth in the control group. Conclusion: Our results suggest that extremely early enteral feedings may play an important role in the development of glicentin secretion and intestinal mucosal growth in the early period of life in VLBW infants.

Background: Human milk contains many kinds of antioxidant and is considered to prevent diseases mediated by oxygen free radicals in very low birthweight (VLBW) infants. Aims: To examine the antioxidant effects of breast milk in VLBW infants by determining urinary 8-hydroxydeoxyguanosine (8-OHdG) excretion, which is known to be a non-invasive marker for in vivo oxidative DNA damage. Methods: Urinary 8-OHdG concentrations were measured in 15 breast fed and 14 formula fed VLBW infants at 2, 7, 14, and 28 days of age. Results: Urinary 8-OHdG excretion at 14 and 28 days of age was significantly lower than at 2 and 7 days of age in the breast fed group, and significantly lower than in the formula fed group. Conclusion: This is the first direct evidence of the antioxidant action of human milk in VLBW infants.

Objective: Previous reports of the postprandial regulation of leptin are controversial, and there have been few studies on the effects of breast-feeding on postprandial regulation in newborn infants. We examined the response of plasma leptin to breast- and formula-feeding in newborn infants. Methods: We measured the plasma leptin levels using an enzyme-linked immunosorbent assay kit before and after feeding in 12 breast-fed and 11 formula-fed mature infants. Results: There was no significant difference in plasma leptin levels in breast-fed infants before and after feeding or in artificially fed infants before and after feeding. Conclusion: Our results suggest that feeding does not play a role in the acute response of circulating leptin levels in either breast- or formula-fed infants.