Low birth weight (LBW) infants have higher risk of developing insulin resistance and its comorbidities later in life. The concept of “developmental origins of health and disease” suggests that ...intrauterine and postnatal environments have an important role in increasing these risks. The risk of such adult-onset diseases in LBW infants might be associated with adipose tissue maldevelopment including altered body composition and increased amount of visceral fat, which is the same mechanism as that in children and adults with metabolic syndrome. However, LBW infants often have different characteristics: they are not always overweight or obese over their life course. The inconsistency might be associated with the thrifty phenotype, which is produced in response to impaired growth potential and decreased lean body mass. LBW infants tend to be obese within the limits of impaired growth potential. Through our previous investigations evaluating longitudinal changes in adiponectin levels at an early stage of life, we speculated that probably, the intrauterine life of term infants or the period up to term-equivalent age in preterm infants might be the key age for the development of adipose tissues including fat cells. Because of that, we hypothesized that the smaller number of adipocytes in LBW infants might be associated with overloading of single adipocytes and impaired adipose tissue expandability. The possible mechanisms are discussed from the perspective of adipose tissue maldevelopment in LBW infants.
Aim: The increase in monocyte chemoattractant protein-1 (MCP-1) and the decrease in adiponectin production from hypertrophic adipocytes are associated with adipose tissue inflammation and its ...metabolic complications. The aim of this study was to determine whether 5-aminoimidazole-4-carboxamide 1-β-D-ribofuranoside (AICAR), an adenosine monophosphate-activated protein kinase (AMPK) activator, modulates these adipocytokine productions in tumor necrosis factor-α (TNFα)-treated adipocytes.Methods: AICAR and/or other reagents were added to the culture medium, and then, TNFα was added to fully differentiated 3T3-L1 adipocytes. The MCP-1 and adiponectin production in the culture supernatant was measured by ELISA. AMPK, phosphatidylinositol 3-kinase (PI3K), and nuclear factor-κB (NF-κB) activities were also assayed.Results: Treatment with TNFα increased MCP-1 and decreased adiponectin secretion dose-dependently in the 3T3-L1 adipocytes, and AICAR significantly inhibited these TNFα-mediated changes. Interestingly, metformin, another AMPK activator, did not have such effects on these adipocytokines. Both the AMPK and PI3K systems in the cells were significantly activated by the AICAR treatment, but the effects of AICAR on adipocytokines were not weakened by the addition of dorsomorphin, an AMPK inhibitor, or LY294002, a PI3K inhibitor. Pyrrolidine dithiocarbamate (PDTC), an NF-κB inhibitor, showed protective effects similar to those as AICAR. AICAR, but not metformin, significantly inhibited the TNFα-stimulated activation of NF-κB, and dorsomorphin did not change AICAR's effect.Conclusion: AICAR attenuates the TNFα-induced secretion of MCP-1 and adiponectin in 3T3-L1 adipocytes. The observed effects of AICAR seem to be mainly due to the inhibition of NF-κB activation rather than the activation of the AMPK pathway, at least in TNFα-treated adipocytes.
Background
The importance of breast‐feeding for very low birthweight (VLBW) infants has been pointed out. Some overseas studies suggested that the standardization of enteral nutrition (EN) leads to ...improved prognosis in VLBW infants. In Japan, however, physicians in charge of infants are responsible for making nutrition management decisions on an individual basis. We conducted an online survey to clarify the course of nutrition management of VLBW infants currently implemented in Japan.
Methods
We mailed a notice to 300 representative neonatologists throughout Japan requesting their participation in the online survey. On the survey website, neonatologists responded to questions regarding the nutritional strategy for five birthweight groups (less than 500 g, 500–749 g, 750–999 g, 1,000–1,249 g and 1,250–1,499 g).
Results
Responses were recieved from 137 neonatologists. The first choice for EN up to 1 week after birth was breast milk regardless of birthweight (92.0% for 1,250–1,499 g to 95.6% for 500–999 g). More than 30% of the respondents answered that they fast infants who weigh <750 g at birth or feed them with other mothers’ breast milk until their own mother’s milk becomes available. The lower the birthweight, the later EN is started, and the greater the number of days to establish EN.
Conclusion
The lower the birthweight, the more difficult it is to feed infants their own mother’s milk and the later the EN is started. If donor milk is supplied in a stable manner, it takes fewer days to establish EN.
The reduction of nitrate ion was conducted on Sn-modified rhodium, ruthenium, and iridium electrodes in 0.1
M HClO
4. These electrodes showed very high electrocatalytic activities for this reaction, ...although they were not as high as those of the previously reported Sn-modified palladium and platinum electrodes. The number of cleaved N–O bonds per reduced nitrate ion was calculated from the product distribution to be 2.2–2.5, independent of the noble metal including Pt and Pd. These results show that Sn-modified noble metal electrodes (Rh, Ru, Ir, Pd, and Pt) are good catalysts for N–O bond cleavage. On the other hand, the product strongly depends on the electrode. The main product formed at −0.2
V vs. Ag/AgCl on Sn/Rh was N
2O (59%), while the remaining products were hydrogenated species such as
NH
3
+
OH
(22%) and
NH
4
+
(19%). On Sn/Ru, only hydrogenated products were formed;
NH
3
+
OH
: 46%,
NH
4
+
: 41%. Sn/Ir showed a product distribution similar to that on Sn/Pt; N
2 (17%),
NO
2
-
(17%), N
2O (11%), and
NH
3
+
OH
(56%). The potential of the electrodes for the selective N
2 formation, calculated on the basis of the number of cleaved N–O bonds, and formed N–N and N–H bonds per reduced nitrate ion, decreased in the order of Sn/Pd
>
Sn/Rh
>
Sn/Pt
>
Sn/Ir
≫
Sn/Ru, although the highest N
2 production was obtained on Sn/Pt.
Distal malignant biliary obstruction is caused by various malignant diseases that require biliary drainage. In patients with operable situations, preoperative biliary drainage is required to control ...jaundice and cholangitis until surgery. In view of tract seeding, endoscopic biliary drainage is the first choice. Since neoadjuvant therapies are being developed, the time to surgery is increasing, especially in pancreatic cancer cases. Therefore, it requires long stent patency. Recently, preoperative biliary drainage using self-expandable metal stents has been reported as a useful modality to secure long stent patency. In patients with unresectable distal malignant biliary obstruction, self-expandable metal stent is the first choice for maintaining long stent patency. Although there are many comparison studies between a covered and an uncovered self-expandable metal stent, their use is still controversial. Recently, endoscopic ultrasound-guided biliary drainage has been performed as an alternative treatment. The clinical success and stent patency are favorable. We should take into consideration that both endoscopic retrograde cholangiopancreatography-guided biliary drainage and endoscopic ultrasound-guided biliary drainage have advantages and disadvantages and chose the drainage method depending on the patient’s situation or the expertise of the endoscopist. Here, we discuss the current status of endoscopic biliary drainage in patients with distal malignant biliary obstruction.
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for diagnosis and intervention in patients with biliopancreatic disorders. However, ERCP in patients with surgically altered ...anatomy (SAA) is considered more difficult than in patients with normal anatomy. Since the introduction of balloon enteroscopes for patients with small intestine disorders, single-balloon enteroscopes (SBEs) and double-balloon enteroscopes (DBEs) have also been used for biliopancreatic diseases in patients with SAA. Nevertheless, the use of conventional SBEs and DBEs is limited, as a balloon enteroscope has a working length of 200 cm and a narrow working channel with a diameter of 2.8 mm; therefore, few ERCP accessories are available for use. A short-type SBE with a working length of 152 cm and a working channel of 3.2 mm in diameter, and a short-type DBE with a working length of 155 cm and a working channel of 3.2 mm were introduced to solve these difficulties. Favorable outcomes of these devices have recently been reported. Moreover, studies have reported several tips to achieve procedural success and factors affecting procedure failure. Difficult cases necessitate alternative techniques, such as percutaneous transhepatic biliary drainage and endoscopic ultrasound-guided biliary drainage.
Aim : The increase in monocyte chemoattractant protein-1 (MCP-1) and the decrease in adiponectin production from hypertrophic adipocytes are associated with adipose tissue inflammation and its ...metabolic complications. The aim of this study was to determine whether 5-aminoimidazole-4-carboxamide 1-β-D-ribofuranoside (AICAR), an adenosine monophosphate-activated protein kinase (AMPK) activator, modulates these adipocytokine productions in tumor necrosis factor-α (TNFα)-treated adipocytes. Methods : AICAR and/or other reagents were added to the culture medium, and then, TNFα was added to fully differentiated 3T3-L1 adipocytes. The MCP-1 and adiponectin production in the culture supernatant was measured by ELISA. AMPK, phosphatidylinositol 3-kinase (PI3K), and nuclear factor-κB (NF-κB) activities were also assayed. Results : Treatment with TNFα increased MCP-1 and decreased adiponectin secretion dose-dependently in the 3T3-L1 adipocytes, and AICAR significantly inhibited these TNFα-mediated changes. Interestingly, metformin, another AMPK activator, did not have such effects on these adipocytokines. Both the AMPK and PI3K systems in the cells were significantly activated by the AICAR treatment, but the effects of AICAR on adipocytokines were not weakened by the addition of dorsomorphin, an AMPK inhibitor, or LY294002, a PI3K inhibitor. Pyrrolidine dithiocarbamate (PDTC), an NF-κB inhibitor, showed protective effects similar to those as AICAR. AICAR, but not metformin, significantly inhibited the TNFα-stimulated activation of NF-κB, and dorsomorphin did not change AICAR's effect. Conclusion : AICAR attenuates the TNFα-induced secretion of MCP-1 and adiponectin in 3T3-L1 adipocytes. The observed effects of AICAR seem to be mainly due to the inhibition of NF-κB activation rather than the activation of the AMPK pathway, at least in TNFα-treated adipocytes.
Late-onset group B streptococcus （GBS） infection in neonates often causes meningitis or bacteremia, but cellulitis or osteoarthritis may also develop in 5％-10％ of cases. We report a case of a preterm ...infant who developed submandibular cellulitis, bacteremia, and meningitis due to late-onset GBS infection and had airway obstruction resulting from submandibular cellulitis. At the age of 61 days, the infant had presented with frequent apnea and lethargy. His treatments included tracheal incubation, mechanical ventilation, and antibiotic administration. The following day, fever, swelling of the entire mandible, and redness from the parotid region to the submandibular region were observed. GBS was detected in the cerebrospinal fluid and blood cultures, confirming a diagnosis of meningitis and bacteremia with submandibular cellulitis. The possibility of infection via breast milk was considered but was excluded when GBS was not detected in the breast milk culture. Extubation was attempted at 66 days of age, but stridor was observed immediately afterward, prompting reintubation. After the swelling of the submandibular region subsided, the patient was successfully extubated at 72 days of age. He was subsequently discharged from the neonatal intensive care unit at 94 days of age without relapse of airway obstruction. Submandibular cellulitis due to late-onset GBS infection is a rare condition. This case confirms that GBS can cause airway obstruction when inflammation spreads around the airways. Additionally, since cellulitis due to late-onset GBS infection is frequently complicated with bacteremia and meningitis, blood and cerebrospinal fluid cultures should be performed immediately.
Background: The roles of adiponectin and leptin in the early stages of life are poorly understood. We previously studied longitudinal changes in these adipocytokines from birth to 12 months of age. ...The aim of this investigation was to evaluate the correlation between cord serum adipocytokine levels and postnatal growth by 3 years of age.
Methods: A questionnaire was sent to obtain the general physical measurements of 3‐year‐olds from 56 healthy newborn infants born at a gestational age of 35 weeks or more; 45 valid responses were obtained. The correlations between variables, including cord serum adipocytokine levels at birth and general physical measurements at 3 years, were investigated.
Results: Body mass index (BMI) Z‐score gain from birth to 3 years was negatively correlated with birthweight SD scores (β=−0.395, P= 0.019) and gestational age (β=−0.557, P= 0.016), and positively correlated with cord serum adiponectin levels (β= 0.253, P= 0.043). BMI Z‐score gain from birth to 6 months was negatively correlated with only birthweight SD score (β=−0.442, P= 0.017). Cord serum leptin levels were not a significant predictor of BMI Z‐scores gain in our subjects. BMI Z‐scores at 6 months, 12 months, and 3 years of age were not related to cord serum adiponectin or leptin levels.
Conclusions: Birthweight SD score, gestational age, and cord serum adiponectin levels are significant predictors of BMI Z‐score gain from birth to 3 years of age in Japanese infants.
To determine the factors associated with high molecular weight adiponectin (HMW-ad) levels during the first year of life, the longitudinal changes in serum HMW-ad were investigated from birth to 12 ...mo of age. The total adiponectin levels, HMW-ad, and leptin were measured longitudinally from birth to 12 mo of age in 56 healthy infants (>or=35 wk of gestation). Serum HMW-ad levels were positively correlated with total adiponectin levels (R2 = 0.93, p < 0.0001). Serum HMW-ad levels at birth, six, and 12 mo were 13.7 +/- 0.9 (mean +/- SE), 13.3 +/- 0.8, and 7.7 +/- 0.5 microg/mL, respectively. The levels at 12 mo were significantly lower than those at birth and 6 mo, respectively. In a multiple regression analysis, the HMW-ad levels at 12 mo were found to be related only to cord blood HMW-ad levels (beta = 0.680, p < 0.001) and not to any other factors. These results imply that postnatal production of HMW-ad at least during infancy may be regulated before birth. Further study is necessary to determine whether cord blood HMW-ad has an effect and whether it is involved in the development of metabolic syndrome.
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