Total parenteral nutrition in pregnancy: conception to delivery.

The delivery of safe and nutritionally successful total parenteral nutrition (TPN), including intravenous lipid emulsion, to a pregnant woman with Crohn's disease and short bowel syndrome from conception to delivery is reported. Maternal nutritional status improved during the pregnancy. Fetal development was normal, and a healthy, full-term infant was delivered. The placenta was normal. Specific intravenous macronutrient and micronutrient requirements during pregnancy are not well defined. Our experience has resulted in the generation of additional recommendations to optimize the intravenous nutritional therapy of this high-risk population.

The influence of subacute dyflos administration on the sensitivity to agonists of longitudinal and circular muscle preparations of the guinea-pig ileum.

1. Changes in the EC50 values to various agonists in longitudinal and circular muscle preparations of guinea-pig ileum were investigated following daily pretreatment of the animals for 10 days with dyflos (1.2 mg/kg, s.c.). 2. In the longitudinal muscle no significant change in sensitivity to acetylcholine and potassium chloride was noted following dyflos treatment. Marked subsensitivity to carbachol and histamine was observed. 3. In circular muscle a marked supersensitivity to acetylcholine occurred and there was no change in sensitivity to carbachol. 4. Dyflos treatment induced an increase in the slope of the log concentration-response curve and the maximal contractile response obtained to agonists in both longitudinal and circular muscle preparations. An increase in tissue mass was also associated with dyflos pretreatment. 5. Subsensitivity development was not attributable to changes in affinity for agonists at the receptor site but rather to changes at the post-receptor level leading to a nonspecific subsensitivity.

Sensitivity changes in guinea-pig atria and ileum following subacute administration of dyflos.

1. Subacute administration of dyflos to guinea-pigs (1.2 mg/kg, s.c., daily for 10 days) led to the development of subsensitivity to carbachol in the ileum but not in the electrically stimulated left atrium. 2. Atria from dyflos-pretreated animals became supersensitive to acetylcholine but the ileum became subsensitive to this agonist despite marked inhibition of cholinesterases. The degree of subsensitivity was less than that for carbachol. 3. Subsensitivity also developed to histamine and was of a similar order to that observed for carbachol supporting the suggestion that subsensitivity is a nonspecific post-receptor mechanism. 4. Other changes which occurred in the ileum, together with the increase in the EC50 value to agonists were an increase in tissue mass, an increase in the slope of the concentration-response curve to agonists and an increase in the maximal response to agonists.