OBJECTIVETo explore the efficacy of Tuina for postpartum lactation and work out a optimal protocol involved.

METHODSWith a randomized, controlled and clinical method, 84 primiparas were divided into a Tuina group and a control group. While patients in the control group received rooming-in conventional managements, those in the Tuina group were additionally treated with Tuina, including local manipulations on breasts combined with acupoint manipulations. The colostrum-time, lactation quantity and prolactin were observed to make the comparisons between two groups.

RESULTSThe scores of lactation quantity after 1th, 2nd, 3rd of the treatment were 1.660 +/- 0.785, 2.530 +/- 1.030, 2.880 +/- 1.171 in Tuina group and 1.270 +/- 0.533, 1.460 +/- 0.811, 1.500 +/- 0.583 in control group respectively, where there were significant differences in each time stage between two groups (all P < 0.001). The time of colostrum was (21.6 6 +/- 10.508) h in the Tuina group and (22.5 +/- 9.762) h in the control group, in which the difference was not statistically significant (P > 0.05). The levels of prolactin (314.35 +/- 110.37) ng/mL and (321.56 +/- 109.61) ng/mL in Tuina group, (385.78 +/- 85.19) ng/mL and (340.12 +/- 103.10) ng/mL in control group before and after treatment, there were no significant differences (both P > 0.05).

CONCLUSIONPostpartum Tuina on breasts could increase the quantity of lactation and delay the decreasing of the levels of prolactin, which contributes primiparas to lactate more and sooner.

Adult ; Amobarbital ; Breast ; secretion ; Breast Feeding ; Colostrum ; secretion ; Drug Combinations ; Female ; Humans ; Lactation ; Milk, Human ; secretion ; Postpartum Period ; physiology ; Prolactin ; metabolism ; Secobarbital ; Young Adult

BACKGROUND/AIMS: For decades, thiopurines have been the mainstay of inflammatory bowel disease (IBD) treatment and will play an important role in the future. However, complex metabolism and various side effects limit the use of these potent drugs in clinical practice. The Korean Association for the Study of Intestinal Diseases developed a set of consensus statements with the aim of guiding clinicians on the appropriate use of thiopurines in the management of IBD. METHODS: Sixteen statements were initially drafted by five committee members. The quality of evidence and classification of recommendation were assessed according to the Grading of Recommendations Assessment, Development and Evaluation system. The statements were then circulated to IBD experts in Korea for review, feedback, and then finalized and accepted by voting at the consensus meeting. RESULTS: The consensus statements comprised four parts: (1) pre-treatment evaluation and management strategy, including value of thiopurine S-methyltransferase screening, dosing schedule, and novel biomarkers for predicting thiopurine-induced leukopenia; (2) treatment with thiopurines with regards to optimal duration of thiopurine treatment and long-term outcomes of combination therapy with anti-tumor necrosis factors; (3) safety of thiopurines, especially during pregnancy and lactation; and (4) monitoring side effects or efficacy of therapy using biomarkers. CONCLUSIONS: Thiopurines are an effective treatment option for patients with IBD. Management decisions should be individualized according to the risk of relapse and adverse events.
Appointments and Schedules ; Biomarkers ; Classification ; Committee Membership ; Consensus* ; Female ; Humans ; Inflammatory Bowel Diseases* ; Intestinal Diseases* ; Korea ; Lactation ; Leukopenia ; Mass Screening ; Metabolism ; Necrosis ; Politics ; Pregnancy ; Recurrence

To elucidate the changes in bone turnover during pregnancy and puerperium, we measured serially the levels of serum osteocalcin and urine deoxypyridinoline (Dpy) as markers of bone formation and bone resorption, respectively, in 22 healthy women with normal pregnancy. Nineteen non-pregnant women served as control. The Dpy levels increased significantly at 16 weeks of pregnancy and remained elevated thereafter. The levels of osteocalcin, however, were significantly decreased at 16 weeks of pregnancy and elevated later at 6 weeks postpartum. Bone turnover ratio (Dpy/osteocalcin) continued to rise during pregnancy, but returned to control levels 6 weeks after delivery. Dpy levels and bone turnover ratio during puerperium tended to be higher in 17 breast-feeding women than those of 5 exclusive bottle-feeders. In conclusion, bone resorption begins to increase from the second trimester of pregnancy and calcium release from bone tissue might play a major role in calcium homeostasis during the whole period of pregnancy as well as during lactation.
Adult ; Amino Acids/urine ; Analysis of Variance ; Biological Markers* ; Bone Resorption/physiopathology* ; Calcium/metabolism ; Female ; Human ; Lactation/physiology ; Osteocalcin/blood ; Osteoporosis/physiopathology* ; Pregnancy ; Pregnancy Complications/physiopathology* ; Puerperium/physiology*

BACKGROUNDOptimal mineral intakes are important for infant growth and development. However, data on mineral compositions of breast milk in Chinese women are scarce, and most were acquired before 1990. The objectives of this study were three-fold: (1) to investigate the mineral compositions of Chinese healthy mothers' breast milk in different lactation stages; (2) to explore correlations among mineral concentrations in breast milk; and (3) to explore the associated factors affecting mineral compositions in breast milk.

METHODSThe inductively coupled plasma mass spectrometry (ICP-MS) was used to analyze mineral concentrations in breast-milk of 444 healthy lactating women from three cities in China. A questionnaire was used to survey socio-demographic characteristics and pregnancy history. Food intakes by lactating women were measured using both food frequency questionnaire and one cycle of 24-hour dietary recall.

RESULTSMineral compositions of breast milk varied in different regions. Concentrations of most minerals were higher in the first one or two months of lactation, and then decreased with time, except for magnesium and iron. Inter-mineral correlations existed among several minerals. The calcium-to-phosphorus ratio was above 2:1 in each lactation stage. Women with caesarean section had higher concentration of iodine in the transitional milk (349.9 µg/kg) compared to women with natural delivery (237.5 µg/kg, P < 0.001). Dietary mineral intakes, supplements, food intake frequencies in the recent 6 months, maternal age and maternal BMI did not show significant correlations with concentrations of milk minerals (all P > 0.05).

CONCLUSIONSMilk minerals decreased with time, and changed most rapidly in the first one or two months of lactation. Caesarean section might affect the iodine level in transitional milk.

Adult ; Calcium ; administration & dosage ; metabolism ; Dietary Supplements ; Female ; Humans ; Iodine ; administration & dosage ; metabolism ; Lactation ; metabolism ; Mass Spectrometry ; Milk, Human ; chemistry ; metabolism ; Minerals ; administration & dosage ; analysis ; Phosphorus ; administration & dosage ; metabolism ; Pregnancy

OBJECTIVETo study the effect of 1,25-(OH)2D3 supplementation during gestation and lactation on TGF-β1 and Smad3 expression in lungs of rat offspring with asthma.

METHODSThirty-two female Wistar rats were randomly divided into four groups: low-, medium- and high-dose 1,25-(OH)2D3 supplementation and control groups (n=8 each). From the 7th day of gestation, the three 1,25-(OH)2D3 supplementation groups were administered with 2,10 and 20 μg/mL of 1,25-(OH)2D3 respectively every other day until weaning (rat offspring: 21 days old). The control group received normal saline instead. Then, bronchial asthma was induced in rat offspring from the 4 groups. The protein and mRNA expression of TGF-β1 and Smad3 in the lung tissue was measured by immunochemistry and RT-PCR.

RESULTSEosinophil cell infiltration and airway inflammation decreased in rat offspring from the low- and medium-dose 1,25-(OH)2D3 groups, but increased in rat offspring of the high-dose 1,25-(OH)2D3 group compared with the control group. Immunohistochemistry of lung tissues showed that the expression of TGF-β1 protein and pSmad3 decreased in rat offspring from the low- and medium-dose 1,25-(OH)2D3 groups (P<0.05), but increased significantly in rat offspring from the high-dose 1,25-(OH)2D3 group compared with the control group (P<0.05). PCR showed that the expression of TGF-β1 and Smad3 mRNA in the lung tissue decreased in rat offspring from the low- and medium-dose 1,25-(OH)2D3 groups (P<0.05), but increased significantly in rat offspring from the high-dose 1,25-(OH)2D3 group compared with the control group (P<0.05).

CONCLUSIONS1,25-(OH)2D3 supplementation plays a role in regulating the immune system in asthmatic rats. Its mechanism may be associated with regulation of the expression of TGF-β/Smad signal pathway-related proteins through the vitamin D receptor signal pathway.

Animals ; Asthma ; metabolism ; Cholecalciferol ; administration & dosage ; analogs & derivatives ; Dietary Supplements ; Female ; Lactation ; metabolism ; Lung ; metabolism ; pathology ; Male ; Pregnancy ; RNA, Messenger ; analysis ; Rats ; Rats, Wistar ; Signal Transduction ; Smad3 Protein ; genetics ; physiology ; Transforming Growth Factor beta1 ; genetics ; physiology

We present an interesting case of incidental diffuse fluorodeoxyglucose (FDG) uptake at PET in her left breast, related to atypical breastfeeding practice. Clinically, differential diagnoses of diffuse intense FDG uptake in unilateral breast include advanced breast cancer, breast lymphoma and inflammatory condition. However, normal physiologic lactation may also show increased FDG uptake in the breasts. Therefore, if we encounter that finding in daily practice, we should question the patient regarding unilateral breastfeeding. In addition, mammography and ultrasound would be helpful to confirm the diagnosis.
Adult ; Breast/*metabolism/radionuclide imaging ; Breast Feeding/*methods ; Breast Neoplasms/radionuclide imaging ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18/diagnostic use/*pharmacokinetics ; Humans ; Lactation/metabolism ; Lymphoma/radionuclide imaging ; Mammography ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use/*pharmacokinetics ; Ultrasonography, Mammary

BACKGROUND/OBJECTIVES: Changes in nutritional status during gestation and lactation have detrimental effects on offspring metabolism. Several animal studies have shown that maternal high-fat diet (HFD) can predispose the offspring to development of obesity and metabolic diseases, however the mechanisms underlying these transgenerational effects are poorly understood. Therefore, we examined the effect of maternal HFD consumption on metabolic phenotype and hepatic expression of involved genes in dams to determine whether any of these parameters were associated with the metabolic outcomes in the offspring. MATERIALS/METHODS: Female C57BL/6 mice were fed a low-fat diet (LFD: 10% calories from fat) or a high-fat diet (HFD: 45% calories from fat) for three weeks before mating, and during pregnancy and lactation. Dams and their male offspring were studied at weaning. RESULTS: Dams fed an HFD had significantly higher body and adipose tissue weights and higher serum triglyceride and cholesterol levels than dams fed an LFD. Hepatic lipid levels and mRNA levels of genes involved in lipid metabolism, including LXRα, SREBP-2, FXR, LDLR, and ABCG8 were significantly changed by maternal HFD intake. Significantly lower total liver DNA and protein contents were observed in dams fed an HFD, implicating the disturbed liver adaptation in the pregnancy-related metabolic demand. HFD feeding also induced significant oxidative stress in serum and liver of dams. Offspring of dams fed an HFD had significantly higher serum cholesterol levels, which were negatively correlated with liver weights of dams and positively correlated with hepatic lipid peroxide levels in dams. CONCLUSIONS: Maternal HFD consumption induced metabolic dysfunction, including altered liver growth and oxidative stress in dams, which may contribute to the disturbed cholesterol homeostasis in the early life of male mice offspring.
Adipose Tissue ; Animals ; Cholesterol* ; Diet, Fat-Restricted ; Diet, High-Fat ; DNA ; Female ; Homeostasis ; Humans ; Lactation ; Lipid Metabolism ; Liver* ; Male ; Metabolic Diseases ; Metabolism* ; Mice* ; Nutritional Status ; Obesity ; Oxidative Stress* ; Phenotype ; Pregnancy ; RNA, Messenger ; Triglycerides ; Weaning ; Weights and Measures

This study was designed to investigate the potential estrogenic effects of perinatal dietary phytoestrogens on the rat uterus. Pregnant rats were divided to three groups provided the following diets: (1) rat chow, (2) rat chow with 7.5% Trifolium (T.) pratense, or (3) rat chow supplemented with 17beta-estradiol (0.5 mg/kg). The dams in each group were kept on the same diet during pregnancy and lactation. Female offspring were euthanized on day 21 at which time body and organ weights were recorded and tissue samples were taken for histology. Immunohistochemistry was performed to detect estrogen receptor alpha (ERalpha) and progesterone receptor (PR) levels. Our results revealed estrogen-like biological effects of perinatal T. pratense exposure. Relative uterus and ovary weights in the experimental groups were increased compared to control. The number of uterine glands and luminal epithelium heights were also increased. However, there were no statistically significant changes detected in the immunostaining intensity of ERalpha and PR between the groups.
Animals ; Animals, Suckling ; Body Weight/drug effects ; Estrogen Receptor alpha/*metabolism ; Female ; Immunohistochemistry ; Isoflavones/*pharmacology ; Lactation ; Maternal Exposure ; Organ Size/drug effects ; Phytoestrogens/*pharmacology ; Plant Components, Aerial/chemistry ; Pregnancy ; Rats ; Rats, Wistar ; Receptors, Progesterone/*metabolism ; Trifolium/*chemistry ; Uterus/*drug effects

OBJECTIVETo study the effects of low pre-pregnant lead exposure level on the mobilization of lead and calcium in maternal skeleton during gestation and lactation in mice.

METHODSSeventy Kunming female mice were randomly divided into the lead exposure or control groups, 36 mice were exposed to lead by drinking water (50 mg/L) and 36 mice were exposed to deionized water for 4 weeks. The levels of calcium and lead in blood and femurs were measured on the 1st, 7th and 14th days during gestation and on the 1st,10th and 21st days during lactation with atomic absorption spectrophotometry using a heated graphite atomizer or flame atomic absorption spectrophotometry.

RESULTSAs compared with the pre-pregnant, at the end of lactation in exposure group the levels of calcium in blood and bones significantly decreased 18.5% and 17.75%, respectively, the levels of lead in blood significantly increased 65.22% and the levels of lead in bones significantly decreased 28.45% (P < 0.05). There was a significant negative correlation between the blood lead level and the bone lead level during gestation and lactation in exposure group (r = -0.904, P < 0.01). There were significant differences of lead and calcium levels during the gestation and lactation between exposure group and control group (P < 0.05).

CONCLUSIONThe lead mobilization in maternal bone occurred during gestation and lactation in mice, which could be accelerated by the low pre-pregnant lead exposure.

Animals ; Bone Remodeling ; drug effects ; Bone and Bones ; drug effects ; metabolism ; Calcium ; blood ; metabolism ; Calcium, Dietary ; Female ; Lactation ; Lead ; blood ; toxicity ; Mice ; Mice, Inbred Strains ; Pregnancy ; Prenatal Exposure Delayed Effects

Docosahexaenoic acid(DHA) is a major fatty acid of the gray matter in brain, especially of the synaptic membranes. Modification of membrane fatty acids by dietary fatty acids may influence membrane characteristics and metabolism of neurotransmitters including it's release and reuptake. The effect of w3/w6 fatty acids in maternal diet on the brain neurotransmitters of the offsptings and their behavioral development were investigated in this study. Adult female rats were fed experimental diets with different contents of w3 and w6 fatty acids throughtout pregnancy and lactation and up to 16weekss of pup's age. Experimental diets consisted of 10 wt% fat: cornoil (CO: source of w6, LA), perilla oil (PO: source of w3, a-LNA) and fish oil(FO: source of lonfg chain w3, EPA & DHA). At 3,7 and 16weeks of age, frontal cortex, corpus striatum, thaltmus and cerebellum were dissected out of the whole brain, and the concentrations of 5-hydroxytryptamines(5-HT), catechoamines,and their metabolites were measured by HPLC-ECD. At 16weeks of age, fatty acid compositions of whole brain were determined by GLC. Physical development test in Y-water maze were performed at 15weeks of pup's age. The concentrations of 5-HT in thalamus & hypothalamus was found to be most significiantly correlated with learning ability(r=0.508, p<0.05). At 15weeks of age, the PO group showed higher learning ability compared to the CO or the FO group. Evemn though the DHA level stays rather constant in thhe brain tissue, the ratios of arachidoni c acid(AA,w6)/EPA+DHA(w3) vary significiantly with dietary fatty acids. DHA is known to fulfill very important structural and/or metabolic funtion in membrane system of the brain and AA and its metabolites may also act as transsynaptic messenger and/or second messenger and as the substrate for the production of many biologically active compounds, such as prostaglandins. Therefore, to accomplish full development of brain, proper supply of AA as well as DHA must be considered. Much more studies are needed to clarify th.
Adult ; Animals ; Brain ; Cerebellum ; Corpus Striatum ; Diet ; Fatty Acids* ; Female ; Humans ; Hypothalamus ; Lactation ; Learning ; Membranes ; Metabolism ; Neurotransmitter Agents* ; Perilla ; Pregnancy ; Prostaglandins ; Rats* ; Second Messenger Systems ; Serotonin ; Synaptic Membranes ; Thalamus