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Nutrition in Breastfeeding: Infants and Nursing Mothers.

Hanyang Medical Reviews.2010;30(1):31-40. doi:10.7599/hmr.2010.30.1.31

Breastfeeding provided by healthy and well-nourished mothers is considered the ideal nourishment for healthy term infants and is believed to cover the infant's nutrient requirements during the first 6 months of life. Breast milk composition varies with time postpartum, during nursing, and with maternal nutrition. The changes of human milk composition with time of lactation seem to match the changing needs of growing infant over time. At a certain age, however, breast milk alone no longer can supply all of the infant's nutritional requirements, and complementary foods and/or supplementation of nutrients are needed to ensure adequate nutrition and growth. The nutritional status of lactating mothers is an important health issue since their nutrition status may influence the nutrient concentration of breast milk, while maintaining the nutrients in the breast milk further depletes their own body store. This review discusses the contribution of breast milk to nutritional needs during infancy, growth patterns of breastfed infants, and recommendations regarding the use of complementary foods and nutrient supplementation. In addition, we also review the effect of maternal nutrition on breastfeeding and the nutritional recommendation for lactating women.
Breast Feeding ; Dietary Sucrose ; Female ; Humans ; Infant ; Lactation ; Milk, Human ; Mothers ; Nutritional Requirements ; Nutritional Status ; Postpartum Period

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Breast Milk for the Premature Baby.

Su Jin CHO

Hanyang Medical Reviews.2010;30(1):24-30. doi:10.7599/hmr.2010.30.1.24

Breast milk is the gold standard for full term babies as well as premature babies. Breast milk provides nutritional, gastroenterological, immunological, neurodevelopmental and psychological benefits to the premature baby. These benefits decrease acute morbidities and provide long term benefits. Despite the knowledge that breast milk is best, many obstacles must be overcome for a premature infant to receive optimal nutrition from breast milk. Insufficient amount and difficulty in pumping are some issues that are easily solved with education and support. Inadequacy of minerals and electrolytes in breast milk after one month may be overcome with the use of commercial fortifiers for the optimal growth of the growing premature baby. The use of donor breast milk is increasing. It is the responsibility of the medical personnel to promote breast milk in premature babies by being concerned about the obstacles and preventing problems from arising beforehand.
Breast ; Electrolytes ; Enteral Nutrition ; Humans ; Infant, Newborn ; Infant, Premature ; Milk, Human ; Minerals ; Tissue Donors

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Breast Feeding and Jaundice.

Young Youn CHOI

Hanyang Medical Reviews.2010;30(1):17-23. doi:10.7599/hmr.2010.30.1.17

Even though there is a strong link between breast feeding and jaundice, it is natural and it may have a partially beneficial role in the neonate. There are two types of jaundice associated with breast feeding. First, insufficient caloric intake during the first week of life may increase serum unconjugated bilirubin concentration, which is known as "breast feeding jaundice (BFJ)". This increased severity of physiologic jaundice results from the increased enterohepatic circulation (EHC) of bilirubin, but not because of a factor in breast milk. Second, prolongation of unconjugated hyperbilirubinemia into the third and later weeks of life in the healthy newborn is a regularly occurring extension of physiologic jaundice, which is known as "breast milk jaundice (BMJ)". This is caused by a factor in breast milk inhibits the glucuronyl transferase in the liver and/or increases the EHC of bilirubin. The acceptable bilirubin level in the full-term healthy breast-fed infant needs to be discussed not only to prevent unnecessary interruption of breast feeding, but also to prevent kernicterus. Optimal breast feeding practices are crucial to prevent the BFJ and to minimize the intensity of BMJ. Further research is needed to clarify the benefit of bilirubin in relation to adaptation of extrauterine life.
Aluminum Hydroxide ; Bilirubin ; Breast ; Breast Feeding ; Carbonates ; Energy Intake ; Enterohepatic Circulation ; Humans ; Hyperbilirubinemia ; Infant ; Infant, Newborn ; Jaundice ; Kernicterus ; Liver ; Milk ; Milk, Human ; Transferases

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Nutrients and Bioactive Factors in Breastmilk.

Jeong Wan SEO

Hanyang Medical Reviews.2010;30(1):8-16. doi:10.7599/hmr.2010.30.1.8

Breastmilk provides the best optimal nutrition for infants, especially for the first few months of life. In breastmilk, there are innumerable immune protective and modulating factors. Also, the nutrients in breastmilk act as immune protective factors. The advantages of breastfeeding are not only for protection from infectious diseases, but also protection from some chronic disease, such as celiac disease, atopy, and obesity. A dose-response relationship of breastfeeding has been reported. For lifelong health, breastfeeding is the first step. In Korea, the majority of mothers obtain information about breastfeeding from internet searching, books and magazines. Physicians should actively and enthusiastically recommend breastfeeding and provide detailed advice and integral information about breastfeeding.
Breast Feeding ; Celiac Disease ; Chronic Disease ; Communicable Diseases ; Humans ; Infant ; Internet ; Korea ; Mothers ; Obesity ; Periodicals as Topic ; Resin Cements

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Physiology of Lactation.

Ee Kyung KIM

Hanyang Medical Reviews.2010;30(1):1-7. doi:10.7599/hmr.2010.30.1.1

To produce milk, four secretory processes are synchronized in the alveolar cell of the mature, functional mammary gland: (1) exocytosis, (2) fat synthesis and secretion, (3) secretion of ions and water, and (4) transcytosis of immunoglubulins and other substances from the interstitial space. Milk is synthesized continuously into the alveolar lumen, where it is stored until milk removal from the breast is initiated. Prolactin mediates the central nervous system regulation of milk secretion, but its influence is modified greatly by local factors that depend on milk removal from the breast. Oxytocin mediates milk let-down by stimulating the contraction of myoepithelial cells that surround the alveoli and ducts. Lactogenesis includes all the processes necessary to go from the undifferentiated mammary gland in the early pregnant animal to full lactation sometime after parturition. The most important factors in initiation of lactogenesis stage II appear to be progesterone withdrawal. The metabolic demands of breastfeeding require an increase in maternal metabolism. Postpartum suppression of fertility is thought to be the result of an alteration in pulsatile gonadotropin releasing hormone secretion from the hypothalamus. Women who wish to ensure against pregnancy during lactation usually are advised to use other contraceptive means.
Animals ; Breast ; Breast Feeding ; Central Nervous System ; Contracts ; Dietary Sucrose ; Exocytosis ; Female ; Fertility ; Gonadotropin-Releasing Hormone ; Humans ; Hypothalamus ; Ions ; Lactation ; Mammary Glands, Human ; Milk ; Milk Ejection ; Oxytocin ; Parturition ; Postpartum Period ; Pregnancy ; Progesterone ; Prolactin ; Secretory Pathway ; Transcytosis ; Water

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Corrigendum: Targeting Interleukin-17 and Th17 in Immune Inflammatory Diseases.

Mi La CHO

Hanyang Medical Reviews.2013;33(2):137-137. doi:10.7599/hmr.2013.33.2.137

This erratum is being published to correct of author name.

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Clinical Applications of Antioxidants.

Ji Hoon PARK ; Gi Ryang KWEON

Hanyang Medical Reviews.2013;33(2):130-136. doi:10.7599/hmr.2013.33.2.130

Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are natural by-products of cellular physiological processes involving metabolism of compounds containing oxygen and nitrogen, respectively. Physiological defense mechanisms against ROS/RNS readily convert them into water or urea, but dysregulation of ROS/RNS production damages cells resulting in abnormal conditions such as uncontrolled growth or cell death. ROS/RNS are closely related to the development of a variety of diseases such as cancer, diabetes, neurodegeneration, vascular disease and chronic inflammation. Thus, it has been proposed that the removal of ROS/RNS may prevent or treat oxidative stress-induced diseases. Some antioxidant molecules are synthesized in the body, while others are obtained from food in the diet including fruits, vegetables, meat and even in natural water. In addition to the natural antioxidants, synthetic antioxidants have been modified from natural chemicals so as to increase bioavailability to target organs and increase stability in the air. In developing novel antioxidants for therapeutic use, some factors to consider are: 1) improved efficacy; 2) low side effects (comparatively clear mechanism); 3) competitive price and 4) improved convenience of dosing. In this review, we will discuss the issues mentioned above and the use of antioxidants in clinical application.
Antioxidants ; Biological Availability ; Cell Death ; Defense Mechanisms ; Diet ; Fruit ; Inflammation ; Meat ; Nitrogen ; Oxygen ; Physiological Processes ; Reactive Nitrogen Species ; Reactive Oxygen Species ; Urea ; Vascular Diseases ; Vegetables ; Water

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Amyloidogenic Protein of alpha-Synuclein.

Jee Eun YANG ; Seung R PAIK

Hanyang Medical Reviews.2013;33(2):123-129. doi:10.7599/hmr.2013.33.2.123

Amyloidogenesis is the key pathological phenomenon commonly observed in various neurodegenerative disorders. alpha-Synuclein is the major constituent of Lewy bodies as a common pathological signature of Lewy body diseases (LBDs) including Parkinson's disease (PD), PD with dementia (PDD), and Dementia with Lewy bodies (DLB). As proteins unfold, they would result in producing either ordered or disordered aggregates unless they are folded back to the native state by molecular chaperones or removed via proteolytic degradation. alpha-Synuclein known as a natively unfolded protein has self-assembled into the ordered protein aggregates of amyloid fibrils which comprise the radiating filaments found in Lewy bodies. Amyloid fibrils are generated via either a template-dependent or template-independent mechanism. The prevalent nucleation-dependent fibrillation accelerates the assembly process in the presence of seeds such as prefibrillar species. As a template-independent process, we have recently proposed the double-concerted fibrillation mechanism in which the oligomeric species of alpha-synuclein act as a growing unit to form the mature fibrils. Despite insufficient understanding of the toxic causes of alpha-synuclein, the oligomeric species have been suggested to be responsible for the cellular degeneration by influencing membrane stability while leaving the amyloid fibrils as a detoxification end product. Alternatively, the transition process from the oligomers to the fibrils has been proposed to affect cell viability. It is, therefore, expected to develop prophylactic and therapeutic strategies toward the synucleinopathies by studying cellular function of alpha-synuclein, molecular mechanism of its assembly into the amyloid fibrils, and their effects on cellular biogenesis. By studying cellular function of alpha-synuclein, its molecular mechanism of assembly into amyloid fibrils and their effects on cellular biogenesis, progress of prophylactic and therapeutic strategies toward synucleinopathy can be seen.
alpha-Synuclein ; Amyloid ; Amyloidosis ; Cell Survival ; Dementia ; Lewy Bodies ; Membranes ; Molecular Chaperones ; Neurodegenerative Diseases ; Parkinson Disease ; Proteins ; Seeds ; Organelle Biogenesis

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Reactive Oxygen Species and Cancer.

Inpyo CHOI

Hanyang Medical Reviews.2013;33(2):118-122. doi:10.7599/hmr.2013.33.2.118

Reactive Oxygen Species (ROS) are a class of signaling molecules that regulate intracellular signaling cascades in response to external stimuli. Once accumulated in cells, they can damage DNA modifying gene transcription and affecting protein expression and function in ways that accelerate tumorigenesis. In cancer cells, the accumulation of ROS can increase cell proliferation and cell invasion into other tissues, while, antioxidant enzymes and molecules can protect cells from oxidative stress so as to maintain cellular homeostatic redox status. Cancer cells often do not have sufficient levels of antioxidant enzymes which are needed to rescue cells from oxidative stress. The redox status of cancer cells appears to be a key factor in maintaining the malignant phenotype. Cancer stem cells, on the other hand, have been shown to maintain low levels of ROS in order to retain their self renewal and differentiation potential, even though the exact mechanism is not known yet. ROS and antioxidant enzymes are novel targets for developing anti-cancer therapeutics. In this review, the current understanding for redox regulation of cancer cells and neoplastic stem cells as well as the role and function of anti-oxidant enzymes and molecules is discussed.
Antioxidants ; Cell Proliferation ; Cell Transformation, Neoplastic ; DNA ; Hand ; Neoplastic Stem Cells ; Oxidation-Reduction ; Oxidative Stress ; Phenotype ; Reactive Oxygen Species

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Mass Spectrometry Analysis for Nitration of Proteins.

Kwang Pyo KIM

Hanyang Medical Reviews.2013;33(2):110-117. doi:10.7599/hmr.2013.33.2.110

Various proteomics and immunological methods including mass spectrometry combined with both liquid and 2-D PAGE, and immunodetection have been employed to identify and characterize nitrated proteins from pathological samples. Nitrosative modifications regulate cellular signal transduction and pathogenesis of inflammatory responses and neurodegenerative diseases. Nitric oxide generates reactive nitrosative species, such as peroxynitrite (ONOO-) that may be involved in a number of diseases. ONOO- can mediate protein tyrosine nitration which causes structural changes of affected proteins and leads to their inactivation. Protein tyrosine nitration is a biomarker of oxidative stress and also influences protein structure and function. Recent advances in mass spectrometry have made it possible to identify modified proteins and specific modified amino acid residues. This review focuses on the significance of protein tyrosine nitration and the progress achieved in analytical methods. Although mass spectrometry of nitrated peptides has become a powerful tool for the analysis of nitrated peptides, the low stoichiometry of protein tyrosine nitration clearly demands the use of affinity chromatography to enrich modified proteins (or peptides).
Chromatography, Affinity ; Mass Spectrometry ; Neurodegenerative Diseases ; Nitric Oxide ; Oxidative Stress ; Peptides ; Peroxynitrous Acid ; Proteins ; Proteomics ; Signal Transduction ; Tyrosine

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