[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[Purpose] Many patients who undergo percutaneous endscopic gastrostomy (PEG) have been given enteral nutrition diets over a long term. We evaluated the fatty acid composition of the patients in long term by using the enteral nutrition diets that the n-6/n-3 polyunsaturate fatty acid (PUFA) ratio is low as 3:1.
[Subjects and method] Using enteral nutrient solution Racol^® that strengthens n-3 PUFA for 18 cases during total enteral nutrition only through PEG catheter, compared the change of fatty acid composition in 132±54 days on the average.
[Result] An α-linolenic acid and the docosapentanenoic acid in the n-3 PUFA increased significantly, and the linoleic acid and the n-6/n-3 PUFA decreased significantly compare to the start of the study.
[Conclusion] There are very few reports about n-6 PUFA and n-3 PUFA evaluation on long-term administration. We found that the chronic administration of the same enteral diet influences the body composition. Serum fatty acid shows a similar composition to the enteral diets when enteral nutrition diets contain proper amount of fattty acid.

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[Introduction] In European and American countries, nutritional support has been performed based on practice guidelines. On the other hand, in Japan, there have been no guidelines established for nutritional support of patients after hematopoietic stem cell transplantation (SCT). We performed a nation-wide survey including 130 SCT centers and obtained feedback from 80 centers (62%) to clarify the present nutritional support.
[Results] For total parenteral nutrition, 39% centers used 1.0-1.3 × basal energy expenditure as a target dose, while 38% centers did not determine the target. Only 18% centers routinely used lipid parenteral nutrition, and 58% centers used only glucose and amino acids. Nutritional support team (NST) existed in 86% , but nutritional support was performed in consultation with NST in only 24% centers.
[Conclusions] In Japan, nutritional support after SCT was quite inconsistent, although this may affect the clinical outcome. More attention should be paid among nurses, dietitians and pharmacists as well as physicians for generalized use of nutritional support.

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[Purpose] We have been proposing the hypothesis of the mechanism of EN catheter obstruction. The first step is the intestinal bacteria proliferation in the enteral formula and consequent PH decrease at the tip of EN catheter. Protein in the formula is degenerated and the formula is going to solidified as the curd. This is the sequential story of the obstruction. We think the fluidity of the enteral formula is not related with the obstruction of the catheter. The purpose of this study is the verification of this hypothesis using the acidic enteral formula with less fluidity, “Fibren YH^®”.
[Methods and Materials] 1) The basic experiment of bacterial contamination and solidification of the enteral formula: Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae ware administrated in 3 usual type formulas and Fibren YH, and cultured. 2) The clinical study of the EN catheter obstruction: Continuous EN was applied to the surgical patients using the jejunostomy, and observed the event of the catheter obstruction.
[Results] 1) 3 usual formulas showed the proliferation of the bacteria as 100 folds and PH decrease, while Fibren YH showed the decrease of the number of bacteria. 3 usual formulas were solidified but Fibren YH was left as fluid during the observation period. 2) 89% (8/9) of the patients who received the usual type formula showed the catheter obstruction, while none of the patients (0/10) who received Fibren YH showed the obstruction.
[Conclusion] This study showed the bacterial proliferation and the consequent solidification of the enteral formula is the reason of the obstruction of the EN catheter. FibrenYH is unlikely to obstruct the catheter.

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